1H i m E lu'. m ;\:\V 'm-M \ if i it feii-** 4 ft,- ;::i^>':'.;; 6199255 *r_war NEW REMEDIES: METHOD OF PREPARING AND ADMINISTERING THEM; THEIR EFFECTS ON THE HEALTHY AND DISEASED ECONOMY, Ge°gheiian, in Dublin Medical Journal, for 1835, and Pereira, Op. cit. p. 242. ACIDUM HYDROCYANICUM. 7 (he cat in two seconds; one dog in five, and the other in ten seconds.r With regard to the parts of the economy that are primarily acted upon by the hydrocyanic acid, there can be but little doubt in designating the nervous system. In no other way can we readily explain the extreme rapidity of its action in fatal cases. When once mixed with the blood, however, out of the body, it altogether changes the character of that fluid, and opposes its coagulation.2 Some of the German writers3 have endeavoured to indicate three grades of its action on the economy. First. In moderate doses, long con- tinued, it occasions a marked diminution in the action of the nervous and vascular systems; vertigo; disposition to syncope: epistaxis as a consequence of thinness of the blood, and a disposi- tion to putrid diseases.4 Secondly. In larger doses, the sedative effect of the acid on the spinal marrow, and the abdominal ganglia, is indicated by feelings of weakness, numbness, tremors, and other involuntary motions of the extremities, involuntary discharge of the urine and faeces, augmentation of the cutaneous and urinary depu- rations; palpitations, anxiety at the prsecordia, weak pulse, and, according to some, headach, especially in the back part of the head; excoriation of the tongue and inner parts of the cheeks,5 and salivation. This last symptom is given by Dr. Christison6 on the authority of Drs. Macleod and Granville.7 It has been suspected, however, that salivation, in these cases, was brought about by the use of an impure acid, containing probably a small quantity of the deuto-chloride of mercury, particularly if the acid had been pre- pared—according to the process of the Dublin College—with bicy- anide of mercury, muriatic acid and water. Mercury is, indeed, asserted to have been actually discovered in the acid by Sylves- ter's test. Thirdly. In still larger doses, violent affections of the spinal marrow, convulsions, trismus, opisthotonos, emprostho- tonos, fainting, &c. are induced. 1 Annales de Chimie, xcii. 59. 2 Magendie, Lectures on the Blood. Lect. xvii. in Lancet, for Jan. 26, 1839, p. 636.° On its Action when injected into the Vessels; see Mr. Blake, in Edin. Med. and Surg. Journ. April, 1S39, p. 339. 3 Richter, Specielle Therapie, Band, x, S. 280. Berlin, 1828; and Osann, loc. cit. S. 527. 4 Encyc. Worterb. B. ii. S. 315. 5 Born, in Rusts Magazin, B. xiii. S. 282. 8 Op. citat. p. 701. 7 Lond. Med. and Phys. Journ. xlvi. 359 and 363 8 NEW REMEDIES. From the results of all his observations, Osann1 infers, that the hydrocyanic acid acts dynamically on the nervous system, by diminishing, depressing, and annihilating its life, and, through the nervous system, affecting the organs of vegetation or nutrition, and of haematosis ;—that it incontestably has a specific relation to the spinal marrow, the ganglions of the abdomen, and the dependent organs ; and hence it is, that, in comparison with other narcotic agents, it is less stupifying, whilst it influences more deeply the phenomena of vegetative or organic life. He properly remarks, however, that the inferences of Jorg,2 from his experiments, are apparently opposed to this view. Jorg considered its effects upon the brain to be excitant, and that it occasioned turgescence of that organ. EFFECTS ON THE ECONOMY IN DISEASE. From the effects produced by the hydrocyanic acid on the healthy body, we may infer the cases of disease in which it may be indi- cated. It is decidedly sedative, allaying nervous irritability and vascular action, and therefore adapted for all cases in which these are inordinately excited. Yet its power, as a medicinal agent, is not as great as was at one time presumed, and as is still presumed by many. In some countries, too, it has found more favour than in others. In Italy, France and England, it has been more exten- sively used than in Germany; yet in many of the Pharmacopoeias of the last country it has been admitted into the list of officinal agents. The great objections that have been urged against it are —its danger, even in a small dose, if not carefully administered ; the difficulty of having it always of the same strength ; the impos- sibility of administering it undiluted, and the danger of giving too strong a dose in consequence of its rising to the surface of water. More than once the difference in the strength of the acid, prepared by different methods, would seem to have given rise to unfortunate results. Orfila3 mentions the case of a sick person, who had used for a length of time the hydrocyanic acid, in increasing doses, with advantage; when, being compelled to send her prescription to another apothecary, the acid he employed was so strong as to pro- duce death, with all the symptoms of poisoning by hydrocyanic 1 Loc. citat. S. 526. 2 Materialien zu einer kunftigen Heilmittellehre. B. i. S 53 117 6 1 oxicologie. ' ACIDUM HYDKOCYANJCUM. 9 acid. For these and other reasons, Riecke, L. W. Sachs, and Osann greatly prefer the Aqua laurocerasi and the Aqua amygda- larum amarum, which, although in other respects not less objection- able, are far less dangerous.1 Possessed of the powerful sedative agency, which has been described, it is not to be wondered at, that the hydrocyanic acid should have been prescribed in a multitude of cases, and, as con- stantly happens, that unsuccessful trials, suggested by the merest empiricism, should have been made with it. In inflammations, especially when accompanied with marked erethism of the nervous system, it has been greatly extolled, and, next to blood-letting, has been regarded by many as one of our most valuable antiphlogistics. The followers of the contro-stimu- lant school esteem it as one of their most efficacious contro- stimulants. In the acute inflammations of internal organs it has been highly recommended by the Italian physicians, Borda and Brera, in thoracic inflammation, after blood-letting, in conjunction with tartarised antimony and similar sedative agents; and by others in enteritis, metritis and nephritis, and in active hemorrhages. In chronic inflammations it has been advised by Granville, Magendie, Heller, Elwert, Behr, Roch, ?, " a stench or smell"—on account of its disagreeable odour. It is met with chiefly in sea water, and in certain animal BROMINUM. 89 and vegetable substances that live therein. It has likewise been found in many mineral waters, of this and other countries, and especially in the salt springs—as of Salina, by Professor Silliman, and of Kenawha, by Professor Emmet. METHOD OF PREPARING. Balard's mode of preparing bromine consists in passing a current of chlorine through bittern, after which ether is added, and the two liquids are strongly agitated. The chlorine decomposes the hydro- bromate of magnesia—the form in which the bromine exists in the bittern—and converts the hydrobromate into a muriate of magnesia, setting the bromine free. The ether dissolves the evolved bromine, the mixture assuming a hyacinth red colour. The ethereal solu- tion is agitated with caustic potassa, by which hydrobromate of potassa is generated ; the ether becoming colourless and pure, and fit to be used for dissolving fresh portions of bromine. When a sufficient quantity of the hydrobromate has been obtained, it is mixed in a retort with peroxide of manganese, and acted on by dilute sulphuric acid, by which the bromine is given off. The sulphuric acid sets free the hydrobromic acid, which, at the moment of its disengagement, is deprived of its hydrogen, by the oxygen of the peroxide of manganese, and is thereby converted into bromine. The bromine passes over in reddish vapours, and is made to condense under water, contained in an appropriate receiver. M. Bussy1 prefers the following form. The mother waters of kelp (Soude de Varecq), after iodine has been precipitated from them by means of chlorine, contain bromine in the state of a metallic bromide, when care is taken to add no more chlorine than is required to precipitate all the iodine. To 1250 parts of these mother waters, 32 parts of peroxide of manganese in powder, and 24 of common sulphuric acid at 66° are added. The mixture is then put into a tubulated glass retort, to which a tubulated receiver is adapted, and to the latter a tube, which dips into a flask. The retort and receiver as well as the tube must be ground so as to fit accurately without lutes or corks, which would be destroyed by the chlorine. Every thing being arranged, the retort is heated until the liquid is made to boil, when the bromine condenses in the receiver under 1 Journal de Pharmacie, Janvier. 1837. 90 NEW REMEDIES. the form of red oily striae, with a small quantity of water. The operation must be arrested when the red vapours cease to be produced. By slightly heating the receiver, without dismounting the appa- ratus, the bromine may be made to pass over into the flask, in which it will condense on cooling. The mother waters used in this preparation should not be rejected, until it is evident on the addition of a fresh quantity of sulphuric acid and oxide of manganese, that they contain no more bromine. Bromine, at the ordinary temperature, is a fluid of a blackish red colour, when regarded in quantities,—but of a hyacinth red when placed in a thin layer between the eye and the light. Its smell is strong and disagreeable, resembling that of chlorine. Its taste is strong. It colours the skin yellow—the colour gradually disappearing of itself. Its specific gravity is 2.966. It is readily set free; and, when volatilised, assumes the form of dark red vapours. It boils at 117°; is soluble in water, and the solution is of a yellow colour. In its chemical relations with other bodies, bromine, as before observed, resembles chlorine and iodine; but the chlorine appears to have more power, and the iodine less, than the bromine, as the bromine is separated from all its combinations by the chlorine, whilst it decomposes the compounds of iodine, and assumes the place of the latter. It forms acids both with oxygen and hydrogen. EFFECTS ON THE ECONOMY IN HEALTH. Experiments have been instituted to discover the influence of bromine on the animal economy, and especially by Barthez.1 In this respect, also, bromine resembles iodine, and like it belongs to the class of irritant poisons. Twelve grains of bromine, dissolved in water and injected into the jugular vein of a dog, destroyed it almost instantaneously. Cough occurred; the respiration and circulation were accelerated; the pupils dilated; the male organ was erect; and these signs were followed by involuntary dis- charge of the excrement, and at times stiffness of the upper and lower extremities. On dissection, Barthez found the cavities of the heart full of coagulated blood, and the lungs gorged with the same 1 De l'Action du Brome, &c. (These) Paiis, 1828. See, also Fournet, in Bulletin General de Therapeulique, Fevrier, 1838. BROMINUM. 91 fluid; in the venae cavae there were dark coagula; and, in the stomach and intestines, small, bloody, blackish cylinders, similar to cylinders of lunar caustic. The same quantity introduced into the stomach caused death in three or four days, when the oesophagus was tied ; when, however, the animal was able to vomit, fifty to sixty drops were requisite. The poison acts less intensely when it is given in conjunction with aliment; it produces coughing, excitement, nausea and vomiting : constant sucking of the tongue was noticed, with frequently extraordinary restlessness and anxiety, and debility gradually aug- menting until death. On opening the body the stomach has been found contracted ; the mucous membrane wrinkled, at times soft- ened, and frequently the seat of roundish ulcerations of an ashy green colour. Near the pylorus, Barthez found black spots, which could be readily scraped off with the back of the scalpel, and left gangrenous ulcers exposed. Barthez recommends magnesia as an antidote to bromine, but he rests his recommendation on a single observation only. Butzke obtained similar results from his experi- ments. In one case, only, in which a dog died a few hours after a dose of three drams of bromine, he found the intestines unchanged, and death could only be ascribed to the paralysing influence of the poison on the nervous system.1 EFFECTS ON THE ECONOMY IN DISEASE. Pourche first used both the pure bromine and the hydro-bromate of potassa for therapeutical purposes. He found it very efficacious in scrofula, especially in dispersing strumous swellings, both when given internally and applied externally.2 In a case of very large goitre it was highly serviceable. Accord- ing to Pourche's observation, it excited heat in the face, headach, dryness of the throat, &c., which, however, soon disappeared. Pourche gave the bromine internally, diluted with forty parts of distilled water, beginning with five or six drops of this mixture, and gradually raising the dose. It has also been added in a dilute state to lotions and cataplasms. The remedy is not, however, much used. Magendie frequently administered the bromine, but more com- monly some of its preparations. He prescribed it in cases in which 1 Christison on Poisons, 3d edit. p. 186. 2 Bulletin General de Therapeutique, No. 14. Juiliet 30, 1837. 92 NEW REMEDIES. the iodine did not appear to exert the proper efficacy, or where the patient had become accustomed to its use. The diseases in which he used it were chiefly scrofula, amenorrhoea, and hypertrophy of the ventricles of the heart. More recently, it has been administered by M. Fournet,1 in cases of chronic arthritis, both internally and externally; but his facts, as he himself remarks, were too few to enable him to deduce any general conclusions as to the therapeutical value of the remedy in those affections. He always gave it in a pure state, in the form of mixture, with a solution of gum: externally, it was applied in the form of alcoholic mixture to the affected joints. The dose was at first two drops in four ounces of the vehicle ; and it was gradually increased by two drops at a time, until as much as sixty drops were given in the twenty-four hours. The alcoholic mixture, used by M. Fournet as an external ap- plication, consisted, at the commencement, of ten drops of the bro- mine to an ounce of alcohol: this was augmented daily by five drops until it reached one hundred and twenty drops. The preparations of bromine are described in other parts of this vol u me. BRUCINA. Synonymes. Brucinum, Brucia, Brucium, Brucine. This alkaloid was discovered by Pelletier and Caventou in 1819, in the bark of the false angustura (brucea antidysenterica). It is found also in small quantities in the nux vomica, and in St. Igna- tius's bean. METHOD OF PREPARING. An alcoholic extract of the false "angustura bark is prepared, which is dissolved in a large quantity of cold water, and filtered, in order to separate the fatty matter. The colouring matter is precipitated by acetate of lead, the excess of this is thrown down by sulphuretted hydrogen gas, and the brucine by an alkaline base, for which purpose mag- nesia may be employed. The precipitate from the magnesia ' Bulletin General de Therapeutique, Fevrier, 1838. I3RUCINA. 93 is then washed, dried, and treated with alcohol, which lays hold of the brucine : this is obtained by evaporation. As the bru- cine is somewhat soluble, the precipitate of the magnesia ought not to be washed too much. The brucine thus obtained is coloured, but it may be procured colourless by forming an oxalate of brucine, and treating it with a mixture of equal parts of alcohol and ether. The oxalate is thus deprived of its colouring matter; after which it is decomposed by magnesia, and the brucine is thus obtained wholly pure and devoid of colour. Pure brucine is of a white colour, and forms regular crystals in the form of oblique prisms, having a base representing a parallelo- gram; it has a pearly lustre, tastes very bitter, and is soluble in 500 parts of boiling water, and in 850 parts of cold. In alcohol it dis- solves readily, from which solution it is obtained in the crystalline form. When exposed to the influence of heat, it melts at a tem- perature very little above that of boiling water. At a higher temperature it is decomposed, and affords the same products as vegetable substances that do not contain azote. With the acids, brucine forms neutral salts, which differ from the salts of strych- nine. The sulphate of brucine crystallises in very fine needles, and resembles the sulphate of morphine, but has a much more bitter taste. The nitrate of brucine does not crystallise, which con- stitutes an essential difference between brucine and strychnine. With an excess of nitric acid, the salt has a beautiful pearly (nacre) colour. EFFECTS ON THE ECONOMY. Brucine acts energetically on the animal economy in the same manner as the false angustura, but much more strongly. It is similar, in its operation, to strychnine, but is considered to be weaker in the proportion of one to ten, according to Pelletier; one to twelve, according to Magendie j1 and one to twenty-four, accord- ing to Andral.2 It requires four grains of brucine to kill a rabbit, whilst half a grain of strychnine is sufficient. A tolerably strong dog, to which three grains of brucine had been given, was affected with symptoms resembling tetanus, but did not suceumb. Pelletier is of opinion that brucine, or rather the alcoholic ex- tract of the false angustura, might be substituted in practice for the 1 Formulaire, &c. des Nouveaux Medicamens, &c. 2 Journal de Physiologie de Magendie, iii, 267, Juillet, 1823. 94 NEW REMEDIES. extract of nux vomica; its operation is nearly the same, whilst there is no danger of its acting too violently. Andral has frequently prescribed brucine, and his deductions are, that we have it far more under our control than strychnine. Like strychnine, it has been given in cases of paralysis with vary- ing success. It would appear to have acted most beneficially in paralysis resulting from lead poisoning. Magendie administered it in two cases of atrophy, one of the leg, and the other of the arm, with success. MODE OF ADMINISTERING. Brucine, according to Magendie, may be given either in pills or tincture ; gradually augmenting the dose. Andral raised it from half a grain to five grains. Magendie recommends, that the alka- loid should always be that obtained from the false augustura; the brucine of the nux vomica being mixed with a portion of strychnine, which adds to its activity, and renders it difficult to determine the dose. The following formulae are recommended by him :— Pilula Brucina. Pills of Brucine. 5<. Brucin. pur. gr. xij. Conserv. rosar. Jss. M. exactiss. et fiant pilulae xxiv. One pill to be begun with—twice a day. Tinctura Brucina. (French, Alcool de Brucine.) Tincture of Brucine. &. Alcohol (36° Areom.) gj. Brucin. gr. xviij. M. Of this tincture, from six to twenty-four drops may be given, in the form of mixture, in any vehicle. Mistura Brucina. Mixture of Brucine. Potio Stimulans. 9<. Brucin. gr. vi. Aquae distillat. § iv. Sacchar. alb. ^ij. M. Dose.—A table-spoonful night and morning. Magendie. CAINC^E radix. 95 CAINC7E RADIX. Synonymes.—Rad. Chiococca;, Cainanse, Caninana;, Cahincae, Kahincae, Serpentaria; Braziliensis ; Cainca Root. Portuguese.—Raiz Crusadinha, R. Preta. German.—Caincawurzel. The plant, which furnishes the root introduced into Europe of late years, and which has since become known as a remedial agent, is the Chiococca auguifuga, of the family Rubiaceoe, sexual sys- tem, Pentandria Monogynia.1 The shrub grows wild in the forests of Brazil, especially in the province of Minas Geraes, and the root is used there against the bites of serpents. This root is of the thickness of the finger, round, and knotty; the surface smooth or irregularly wrinkled; the wood tough and of a whitish colour ; the smell disagreeable, especially that of the fresh root; and the taste at first like that of coffee, but afterwards nauseous and pungent. The bark of the root alone possesses efficacy, the woody portion having no action. The bark separates readily from the wood ; it is thicker on the root itself than on its branches : and on the out- side, is of an amber or brownish yellow green colour; yellower and brighter on the youngest parts : the epidermis is not easily sepa- rated. According to the chemical investigations of Pelletier and Caventou,2 the following are found to be the constituents of the bark:—1. A bitter principle, crystallisable in small, white, silky, shining needles ; inodorous, and very soluble in hot alcohol, which communicates to the whole plant a degree of astringent bitterness, and at the same time has an acid reaction on litmus paper. In order to separate this acid, which has been termed by those che- mists the Acidum Cahincicum, in a pure state, the alcoholic ex- tract of the root must be dissolved in water, filtered, and precipi- tated by lime, until the fluid loses all bitterness; the precipitate is then decomposed by oxalic acid and boiling alcohol; or the acetic or muriatic acid may be dropped into an aqueous decoction of the bark of the root, and, in the course of a few days, the acidum cahincicum will separate in the form of small crystals. With the cahincic acid, prepared in this way, however, some colouring matter is still united. 2. A fatty, green, nauseous smelling sub- 1 Art Chiococca, in Encyclopad. Worterb. vii, 521. Berl. 1831, and Von Martius, Spec. Mat. Med. Brasil, i, 18. * Journal General de Medecine, Mai, 1830, and Phil. Journ. of Pharmacy, iii, 1G5. Philad. 1831. 96 NEW REMEDIES. stance, which communicates to the plant its smell. 3. Yellow colouring matter, and 4. A viscid colouring matter.1 EFFECTS ON THE ECONOMY. The effect of the cainca root seems to be especially exerted on the digestive and urinary organs. It occasions watery evacuations and diuresis. From the experiments, however, of Albers2, made on a great number of dropsical patients, in the Charite at Berlin, he was induced to deny its diuretic powers, and to place it amongst the drastic purgatives, by the side of the helleborus niger. Wolff was of the same opinion. According to Von Langsdorf,3 it is a highly efficacious emmenagogue, possessing also—to use his own lan- guage—considerable resolvent virtues, and hence employed in dropsies, that are connected with obstructions in the abdomen. Riecke,4 asserts, that he had occasion to employ it in two cases of ascites complicated with induration of the liver. He had no ex- pectation of effecting a radical cure, but it afforded no palliation ; diuresis was not excited, whilst nausea, colic, and diarrhoea super- vened, so that he discontinued it: he gave it in decoction. Others have observed the same inconvenience from its use, or have found it wholly ineffectual; for example, B. Heyfelder, Reinhardt, Bar- tels,5 and others. Riecke suggests the possibility, in these cases, of adulteration of the drug. On the other hand, the cainca has beep highly extolled by Francois, Ribes, Wagner, Solieer, Lowenstein,6 &c. but particularly by Von Langsdorf. The main diseases in which the cainca is recommended, are, First. Dropsies, in which many favourable trials have been made by Von Langsdorf, Spitta,7 Guddoy, Engler, Francois, Wagner, Solieer, Robredo,8 &c. Secondly. Intestinal worms, against which it ap- pears to act like other drastics. Thirdly. In obstructed menstrua- tion ; on this subject, however, farther trials are needed. When it 1 Journal de Pharmacie, xvi, 465. 2 Medicin. Zeitung. No. iv. Sept. 1832. 3 Hecker's Litter. Annal. B. iv. S. 395, and Rust's Repertorium, B. xiv. S. 458. 4 Die neuern Arzneimittel, u. s. w. S. 84. Stuttgart, 1837. 6 Grafe und Wallher's Journal der Chirurgie, u. s. w. xxiv, S. 470. Ber- lin, 1836. 6 Deradice Caincae ejusque in morbis hydropicis virtute. Berol. 1828. 7 Hecker's Litlerar. Annal. iv. 396. 8 Journal dc la Aeademia de Medicina de Megico. Oct. 1836, and Brit, and For. Med. Review, p. 562, Apl. 1S38. CA1NC/E RADIX. 97 operates as an emmenagogue it is probably altogether like cathartics that act more especially on the lower part of the bowels, that is, by contiguous sympathy. Fourthly. M. Francois has recommended it highly in catarrhus vesicae, but the experience of others has not confirmed this.1 It may be mentioned, that in its native country, it is used for rheumatic pains ; in a peculiar kind of pica experi- enced by the negroes of South America ; and, as already remarked, against the bites of serpents. MODE OF ADMINISTERING. The cainca is given in various forms—powder, infusion, and decoction ; and, besides these, a tincture and an extract have been made of it. A syrup and a wine have also been recommended. To form the latter, one ounce of the powdered root is infused in a pint of wine ; the tincture is made with one part of the root and eight parts of alcohol at 20°. The alcoholic extract is considered to be the most uniform in strength, and has therefore been preferred by many. The syrup is formed by dissolving 3iiss of the extract in a little alcohol, mixing this with a pint of hot simple syrup, and allowing it to boil for some time, in order that the alcohol may evaporate. The dose of the powder is from 9i to 3ss in the twenty- four hours. It appears, however, to be the most objectionable form, and to give rise to unfavourable symptoms more frequently than the others. Opinions vary as to whether the infusion or the decoc- tion should be preferred. According to Caventou and Pelletier, boiling extracts very well the efficacious parts of the root, and there are cases in which the decoction has rendered essential ser- vice after the infusion had been administered without success. Of the decoction, from 3j to 3iij are given in the day. Of the extract the dose, in the twenty-four hours, is twenty to thirty grains ; of the tincture 3j to 3ij.2 The decoction, used by Spitta and others, was made as follows: Decoctum Radicis Cainca. Decoction of Cainca Root. It. Rad. caincae, £ij. Coque cum aquae commun. Ibiss ad dimidiam partem, et cola. Dose.—A table-spoonful three times a day. Von Langsdorf.3 1 Bulletin General de Therapeutique, No. 13, Juillet, 1S37. 2 Journal de Chimic Medicale, Mai, 239-242. Paris, 1827. 3 Hufeland und Osann's Journ. B. lxii, St. 2. 13 98 NEW REMEDIES. By others, the following form has been employed. &. Rad. cainc. §j. Aquae commun. ffiij. Coque ad dimidiam partem et cola. Dose.—Two table-spoonfuls three or four times a day. Engler. Dr. John H. Griscom,1 of New York, considers there is a remark- able analogy between the cainca and the apocynum cannabinum, The Acidum Cahincicum, described above, is said to possess tonic, cathartic and diuretic powers, and has been used successfully in some cases by Francois, in the dose of six grains gradually in- creased to fifteen. CALOIS CHLORIDUM. Synonymes. Calcis Hypochloris, Oxychloruretum Calcii, Protochlorure- tum Calcii; Chloruretum Oxydi Calcii, Bichloruretum Calcis, Oxymurias Calcis, Calx Oxymuriatica, C. Chlorinata, Calcaria Chlorata, Chlorum Calcariae, Chloretum Calcariae, Calcaria Chlorica, Chloride or Chloruret of Lime, Tennant's Bleaching Powder. French.—Protoxichlorure de Calcium, Oxichlorure de Chaux, Chlorure d' Oxide dfi Calcium, Bichlorure de Chaux, Oximuriate de Chaux, Muriate Suroxigene ou Oxigene de Chaux, Chlorate ou Souschlorate de Chaux, Poudre de Blanchement, Poudre de Tennant. German.—Kalkchlorid, Chlorkalk. Chloride of lime is a compound of chlorine and calcium. METHOD OF PREPARING. It may be prepared either in the dry or moist way. In the for- mer case, the chloride is made to act on the hydrate of lime in a pulverulent form; in the latter, the chlorine, in a gaseous state, is passed into lime water. For technical purposes, the latter is most used; for pharmaceutical, the former. In the London pharmaco- poeia, it is directed to be prepared as follows :—" Take of hydrate of lime a pound, chlorine as much as may suffice; send in the chlorine to the lime in a proper vessel, till it is saturated. Chlorine ' Amer. Journal of the Medical Sciences, for May, 1833, p. 55. CALCIS CHLORIDUM. 99 is very easily evolved from binoxide of manganese, mixed with muriatic acid, by a gentle heat." l The chloride is generally however obtained from large chemical establishments. Chloride of lime has the appearance of a white, loose powder, of a sour, bitterish and somewhat biting taste, exhaling a marked smell of chlorine, and dissolving with tolerable facility in water, at the same time giving off much chlorine gas.2 EFFECTS ON THE ECONOMY. The action of the chloride of lime is generally esteemed to be analogous to that of the liquid chlorine; Hufeland, however, assi- milates it to that of the muriate of lime. The data have been con- sidered as scarcely, perhaps, sufficient to determine its precise operation. It appears to us, however, to act mainly by means of its chlorine, which, being loosely combined, is readily disengaged ; — all acids, even the carbonic, occasioning its separation. It is not much employed internally, but according to Cima, who gave it in scrofulous affections, it occasions slight pains in the abdomen, burning in the stomach, and at times diarrhoea. As to its internal administration Cima, it has been observed, gave it in cases of scrofulous swellings. By Cloquet it was used both internally and externally, in gangrenous ulcers; and by Grafe, Deschamps, and Graves,3 in cases of foetor oris. In a case of pectoral disease, with great foetor of the breath and expectoration, it was administered by Drs. Graves and Stokes with remarkable benefit. A pill of three grains of the chloride with one of opium being given three times a day, and the quantity being increased to twelve grains a day: the bed was also sprinkled with a solution of the chloride. By Reid4 it was administered in dysentery, and in a bilious typhus occurring in summer ; by Dr. Copland5 in the last stage of typhus fever, when the evacuations were highly offensive, given in draughts 1 Brande's Dictionary of Materia Medica, p. 135. Lond. 1839. 2 Link, Art. Chlor, in Encycl. Worterb. der Medicin. Wissenschaft. vii, 579. Berlin, 1831. 3 Dublin Hospital Reports, vol. v. * Transactions of the Association of Fellows and Licentiates of the College of Physicians in Ireland, vol. v. 1838. 6 Houlton's Appendix to translation of Magendie's Formulary, p. 163. 100 NEW REMEDIES. of aromatic water with mucilage; by Groh, Cohen, and S-chlesier1 in phthisis, and by Grafe in gonorrhoea. In none of these cases is it presumable, that the chloride of lime possesses virtues not contained in liquid chlorine. For external use it has been adopted in various cases, and espe- cially in ulcers. According to Trusen, an aqueous solution of the chloride is proper for torpid ulcers of almost all kinds—the pha- gedenic, the scrofulous, &c. In syphilitic ulcers it appears to be of use when the chancre is sloughing, and eats deep into the flesh.2 Trusen employed the solution formed by rubbing from 3iij to 3iv. of chloride of lime with a pint of water, pouring off the supernatant fluid after it had stood a quarter of an hour, and applying it by means of pledgets of lint to the .ulcer, renewing the application whenever the lint became dry. In this way he found the profuse ichorous secretion from old ulcers diminish, the offensive odour abate, and fresh and healthy granulations spring up. By the same kind of treatment, phagedenic, herpetic, and scrofulous ulcers generally cicatrised speedily and permanently.3 Trusen employed, at the same time, the antimonium crudum with cathartics; and in all cases he directed strict repose and regu- lated diet. Trusen's observations have been confirmed by many modern physicians, amongst whom may be mentioned Labarraque, Lis- franc, Eld, Lemaire, Heiberg, and Kopp. In ozasna good effects were observed from it by Horner,4 Awl,5 Heron,6 and Strathing: and a solution of it, in the form of injection, was found serviceable in fistula, by Trusen and Ricord. Even in cancerous ulcers, recourse has been had to it by Heiberg, Labarraque, &c.: and in all cases it corrected the offensive odour, and, at times, the ulcer itself assumed a more favourable appearance. Dr. Frohlich7 used it with advantage in a cancerous affection of the face, in the strength of one part of the chloride to sixteen parts of water. In such cases it has been recommended, in order to have the 1 Casper's Wochenschrift fur die gesammte Heilkunde, No. 37, 1838. 2 Dr. Mene, in Gazette Medicale, Feb. 11, 1832. 3 See, also, Houlton's Appendix to Magendie's Formulary, p. 162. 4 Amer. Journ. of the Medical Sciences, No. xi. s Ibid. No. xxii. for Feb. 1833, p. 543. 6 Ibid. Nov. 1836, p. 271. 7 Medicin. Jahrbiicherdes k. k. osterreich. Staates. B. xvii. S. 168. Wien, 1834. CALCIS CHLORIDUM. 101 concentrated action of the chloride, that it should be formed into a paste by admixture with water, and be applied in this manner. It has been used, also, in cases of ulceration of the mouth, by Kopp, Angelot, Heiberg, &c, applied either in the form of solution or of a soft paste. In cases of wounds the application of a solution of the chloride has been recommended by many, as by Trusen, Ekl, Lisfranc,1 to promote cicatrisation after the inflammation has subsided. In a case of punctured wound, received in dissecting, and when the inflammation was proceeding up the arm with alarming rapidity, and the pain and tension were extreme, the patient experienced immediate relief from a solution of the chloride used as a lotion, combined with the free use of leeches.2 Gubian3 has proposed to apply a solution of it to prevent the pitting from small-pox. The maturated pustules are to be opened and washed with a weak solution; desiccation takes place very promptly, and, it is said, no marks or pits are left. On account of its antiseptic properties, the chloride has been applied in cancrum oris by Labarraque, Richter, Berndt, and numerous others, and in the sloughing affections of the female organs of generation of an analogous nature, by Labarraque and Ekl; in hospital gangrene by Percy, Labarraque, Siedmogrodzki, Delpech, and Renard; in gangrene of the scrotum, as well as in ordinary gangrene, by Heiberg and Trusen, in all of which cases it has been of decided efficacy.4 In such cases it may be applied either in the form of the paste above mentioned, or in strong solution—§ij. to ftj. of water. In burns of the second and third degree, when they are not spread over too great a surface of the body, a solution of the chloride of lime, according to Trusen, markedly diminishes the pain, moderates the too great suppuration, and excites, especially in the second degree, sound granulations, and in the third, speedy sepa- ration of the dead portions, and in both cases a smooth and firm cicatrix. Either a solution of the chloride united with mucilagi- nous substances, or a liniment prepared of the chloride may be applied. 1 Bulletin General de Therapeutique, Juillet, 1838. 2 Alcock, Essay on the use of the Chlorurets, &c. London, 1827. 3 Journal de Chimie Medicale, vi. 315. * Riecke, Die neuern Arzneimittel, u. s. w. Stuttgart, 1837. 102 NEW REMEDIES. Lisfranc's observations1 entirely accord with those of Trusen. Lisfranc applies compresses spread with cerate over the burnt parts; the compresses having holes in them so that the burnt places are exposed ; they are then covered with lint soaked in a solution of chloride of lime, which is kept in situ and moistened as it becomes dry. A solution of the chloride of lime, as well as of the chloride of soda, may be applied, indeed, with advantage in the first stage of a burn or scald; and Mr. Holt2 affirms that he knows nothing so effica- cious in a " black eye." Dr. Chopin,3 too, affirms, that in wounds produced by contusion, laceration, or by the explosion of gunpowder, where there is much pain, speedy and certain relief is produced by the chloride of lime, the dressings being kept constantly wet with a solution of it; he found it, as well as the chloride of soda, very serviceable also in cases of sore nipples. In chilblains the chloride has been used, both in the form of solu- tion and of liniment with advantage; and not only in ulcerated pernio, but where the skin was unbroken, by Trusen, Lisfranc, Grafe and others. In many cases, however, it has been found advan- tageous to diminish the inflammation by the application of leeches before it was employed. In cases of deeper frost bites than those which produce pernio, the chloride has likewise proved bene- ficial. In salivation, caused by mercury, this agent has been found valuable,4 especially when administered at the beginning of the increased secretion. When the ptyalism has proceeded to a greater extent, Trusen uses, at the same time, sulphureous baths. A col- lutory of the chloride of lime not only diminishes the excessive secretion from the salivary glands, but speedily mitigates the sense of burning in the mouth ; induces the healing of the erosions of the mucous membrane, and corrects the mercurial foetor. In such cases, we have frequently employed it and with advantage, although the affection is not much under the control of medicine. In offensive odours from the mouth, arising from carious teeth, Regnard employed a solution of the chloride, but it excited the 1 Gazette Medicale, Mars 21, 1835. See also Bulletin General de Therapeutique, Juillet, 1838. 2 Lancet, April 6th, 1833. 3 Gazette Medicale, Oct. 31, 1835. 4 EUiotson, in Mr. Houlton's Appendix to translation of Magendie's Formulary. Amer. edit. p. 162. Philad. 1834. CALCIS CHLORIDUM. 103 salivary glands in a disagreeable manner. On the other hand, E. Grafe recommends it strongly in this very case, and even in caries itself, both inwardly and externally as a collutory and tooth powder. In the latter form it is said to remove speedily the tartar and yellow depositions on the teeth. By Chevallier and Kluge the chloride is strongly recommended for cleansing the mouth. The latter gives a formula for a collutory, which will be found amongst the prescriptions at the end of this article. It effectually cleanses the mouth, whilst it does no injury to the enamel. In scarlatina, a solution of the chloride may be employed most advantageously as a gargle, and in the form of ablution to the surface.1 In scrofulous swellings of the glands, the chloride of lime, according to Cima, may be applied with advantage in the form of ointment, and by Grafe it is recommended in swellings of the joints. It has likewise been used successfully by Werneck in goitre. In several chronic eruptions, it has been much extolled—as in herpes, by Kopp; in the itch, by Heiberg, Derheims,2 Cluzel, Fantonetti,3 Hospital,4 and Wittzack5; in pruritus pudendi mulie- bris, by Darling ; and in tinea, by Trusen, Roche, Cottereau, Kopp and Ebermeier. In the last disease, it is applied in the form of liniment; in the others, in solution, but in the itch often also in the form of ointment. Michaelsen recommends the following method of treating the itch. Take of the chloride of lime from two to four ounces, according to the degree in which the disease exists, and the length of time it has been in the system; put this in a common flask or bottle full of rain or river water, so that as much as possible may be dissolved. In using it, the patient must shake the bottle well, in order that some of the undissolved lime may be taken up. With this, he washes the parts affected with the itch three or four times a day. Every third or fourth day, when the skin becomes somewhat rough or irritated, the patient is made to take a tepid bath, or to wash himself with warm soap and 1 Dr. Copland, in the Appendix to Houlton's edition of Magendie's Formulary, p. 163. Dr. S. Jackson, of Northumberland, (now of Philadel phia,) in Amer. Jouinal of Med. Sciences, xii. 261 and 550, and Ibid, for May, 1838, p. 56. (Dr. J. uses the chloride of soda.) 2 Journal de Chimie Medicale, ii. 575. 3 Bulletin de Therapeutique, 1833, and American Journal of the Medical Sciences, August, 1833, p. 533. 4 Amer. Journal of the Medical Sciences, Nov. 1834, p. 240, (extracted). B Casper's Wochenschrift, Feb. 4, 1837, S. 79, 104 NEW REMEDIES. water, and this until the cure is accomplished. The internal management is the same as in other plans of treatment. In the case of young children, the mixture must of course be weaker, about one ounce to a pound of water. By this plan, the patient, it is said, is entirely cured, without any unpleasant concomitants, in from seven to ten days. The chloride of lime has likewise been applied in purulent ophthalmia. Varlez1 cured contagious blennorrhoea of the eye, by dropping upon it a solution of the chloride. Colson, Delatte, and Reynaud,2 also saw good effects from it, both in acute purulent ophthalmia, and in chronic ophthalmia with granulations, obscurity of the cornea, and especially in copious secretion from the meibo- mian glands. Guthrie3 applied a solution of the chloride suc- cessfully in three cases of ophthalmia neonatorum; and Pereira4 advises a weak solution in the same cases. Farvagnie used it bene- ficially in scrophulous and catarrhal ophthalmia.5 The chloride has likewise been employed advantageously in other blennorrhceas besides the one mentioned, and especially in the gonorrhoeal.6 Grafe, of Berlin,7 affirms that he succeeded with it when copaiba and cubebs had failed. He used it both in the form of pill, made as described hereafter, and of injection—the injection being made by dissolving gr. xxiv. in §vj. of water, and adding 3ss. of wine of opium. But one of the most important of the applications of the chloride is as an antiseptic and disinfecting agent.8 It is admirably adapted for preventing and checking putrefaction, and for correcting the offensive odour of parts already putrefied :9 and hence its applica- tion is most useful in anatomical investigations.10 Some time before dissection, the body may be enveloped in a cloth wetted with a 1 American Journal of Med. Sciences, i. 459. 2 Journal fur Chirurgie, u. s. w. B. xiv. H. 4. 3 Medical and Physical Journal, Nov. 1827. 4 Elements of the Mat. Med. pt. i. p. 354. London, 1839. 5 Verhandlung der vereinigt. arztlich. Gesellschaft. der Schweiz. Jahr 1829. Zurich, 1830. 6 Alcock, Essay on the use of Chlorurets, &e. London, 1827. 7 Amer. Journal of Medical Sciences, and Amer. Journal of Pharmacy, 2d series, vol. ii. 86. Philadelphia, 1838. 8 Labarraque, on the use of the Chlorides of Soda and Lime, translated by Jacob Porter. New Haven, 1829. 9 Alcock, Op. cit. 10 Magendie, Formulaire, &c. CALCIS CHLORIDUM. 105 solution of the chloride, which must be kept wet by sprinkling it from time to time with a solution made of §j. of the chloride to a pint of water; in this manner the offensive odour is speedily corrected. The chloride is equally well adapted for purefying the air of the wards of hospitals, jails, ships; a little of the solution being sprinkled from time to time on the floors ; or shallow vessels, containing the chloride, being placed in different parts of the room. It is used, moreover, for neutralising contagious miasmata dispersed in the air or contained in clothing, furniture, &c. care being taken in all these cases that due ventilation be practised. It has been doubted, however,1 and even denied, that its use is productive of any advantage in preventing the spread of infectious, contagious, or epidemic diseases. Nay, it has been affirmed to be positively injurious, by deteriorating the atmosphere, and in this there may be truth, unless the precautions we have mentioned be taken. In various cases, in which such diseases have prevailed, it has destroyed all offensive odour, but the extension of the malady has not been prevented. MODE OF ADMINISTERING. The chloride of lime has been given internally both in the form of solution and of troches, the dose being from gr. j. to grs. vj. four to six times a day. Externally, it is generally applied in solution of different strengths, (from 3j. to 3iv. to eight ounces of water)— the solution being decanted to remove the particles of lime from it, unless where it is considered advisable to employ the turbid solution. In cases of very offensive evacuations from the bowels, ten or fifteen grains may be added to a common enema. It is likewise applied in the form of ointment and liniment, and also of a paste made by admixture with water. 1 Observations on the chlorides and chlorine as "disinfecting agents," and as preventives of cholera. By H. Bronson, M. D. Boston, 1832. See, also, American Journal of the Medical Sciences, for Feb. 1833, p. 481; Dr. Albers, in London Med. Gaz. viii. 410, as to its inefficacy in cholera; and Pereira, Op. cit. p. 352. London, 1839. 11 106 NEW REMEDIES. The following forms have been given for its administration.1 Trochisci Calcis Chloridi. Lozenges of Chloride of Lime. S<. Calcis chlorid. gij. Sacchar. alb. §viij. Amyl. gj. Gum tragac. 3j. Carmin. grs. iij. M. Fiant trochisci. pond. gr. iij. One of these to be taken three or four times a day, and allowed to dissolve in the mouth, in cases of foetor oris. Deschamps. Mistura. Calcis Chloridi. Mixture of Chloride of Lime. g<. Calcis chlorid. 3j. Emuls. amygd. gvij. Syrup, gummos. §j. M. A table-spoonful every three hours in gonorrhoea. E. Graefe.2 Pilula Calcis Chloridi. Pills of Chloride of Lime. 3>. Calcis chlorid. 3j. Ext. opii, gr. ix. Mucilag. gum. arab. q. s. Divide in pilulas liv. Dose.—One every two or three hours in gonorrhoea, gradually increasing the dose until eight, ten, or twelve are taken every hour. Graefe. Collutorium Calcis Chloridi. Collutory of Chloride of Lime. %. Calcis chlorid. grs. xv. ad ^ss. Mucil. gum. arab. gj. Syrup, cort. aurant. gss. M. 1 Riecke, Op. cit. S. 94. 2 Journal fur Chirurgie, u. s. w. B. xiv. St. 2. CALCIS CTILORIDUM. 10? A little of this solution to be applied by means of a mop of charpie to ulcers in the mouth. Anoelot. fy. Calcis chlorid. giij. Aquae distillat. Alcohol, aa. ^ij. 01. rosar. gtt. iv. Solve et filtra. Chevallier. A tea-spoonful of this solution is mixed with a glass of water, and used in foetor oris. According to Riecke,1 an analogous nos- trum has been sold at a high price under the name—Pneumoka lharterion. &. Calcis chlorid. £j. Solve leniter terendo in Aqure distillat. Ibvi. Tunc adde Alcohol, puriss. (.830) pond. spec. 5viij. Mist, reponatur in loco frigido per horas xxiv; tunc filtretur et reserv. in lagena bene obturata. ("Let the mixture be put aside in a cold place for twenty-four hours; then let it be filtered and kept in a well stopped vessel.") It has been recommended that the mouth should be rinsed with this after the teeth have been brushed. Freyberg von Kluge. The Pharmacopoeia of Sweden has an antiscorbutic collutory, called Linctus ad stomacacen seu oxymuriatis calcici, which is formed as follows: 5*. Solut. calcis chlorid. 3ss. Aquae fontan. Mellis, aa. ^vj. M. fy. Calcis chlorid. 5ss. Solve exactiss. trituratione in Aq. fontan. ,§ij. Et post limpid, clarificat. admisce Alcoholis, 3ij. 01. rosar. gtt. iv. M. The mouth is rinsed in cases of salivation with a mixture made by adding a tea-spoonful of the solution to a glass of water. Trusen. 1 Op. cit. S. 94. 108 new remedies. Solutio Calcis Chloridi. Solution of Chloride of Lime. &. Calcis chlorid. giij. Solve in Aquse distill, ffij. Adde Tinct. opii crocat. vel Vini opii, 3j ad gij. M. Applied to frost-bites. Trusen. &. Calcis chlorid. ^ss. Tere invicem et sensim affunde Aq. font, (seu rosar.) Bj. Et post clarificat. limpid, admisce Mucil. gum. arab. (seu sem. cydon.) gij. Applied by means of linen rags in cases of burns. Trusen. B<. Calcis chlorid. ^ij. ad ^iij. Aquae. ISi. Solve. To be applied by means of rags kept constantly wet, in cases of hospital gangrene ; the mixture being shaken. Rust and Kluge. The disinfecting liquor of Labarraque, Liqueur desinfectante de Labarraque, is made by adding ten parts of water, to one part of the chloride of lime divided in a mortar; suffering the solution to settle, and then filtering. Collyrium Calcis Chloridi. Collyrium of Chloride of Lime. &. Calcis chlorid. gr. iv. ad vj. Laudan. liquid. Sydenham. 9ss. Mucilag. gum. arab. £iss. Aq. rosar. ^ij. M. et filtra. To be dropped in the eye in cases of catarrhal and scrofulous ophthalmia. ( Farvagnie. calcis calendula. 109 Cataplasma Calcis Chloridi. Cataplasm of Chloride of Lime. *. Calcis chlorid. Sodse muriat. aa. §ss. Aquae distill, ftss. Farinae sem. lin. q. s. ut fiat cataplasma. Used in cases of scrofulous swelling of the joints. Graefe. Unguentum Calcis Chloridi. Ointment of Chloride of Lime. &. Calcis chlorid. gj. Axungise, §j. M. fiat unguentum. To be rubbed in, in cases of scrofulous swellings. Cima. 5<. Calcis chlorid. ^ss. * Axung. porcin. gj. M. F. unguent. Used in goitre. Werneck. *. Axung. gj. Boracis venet. Calcis chlorid. aa. 3J. M. exactissime. In cases of chilblains. Trusen. g<. Flor. sulphuris, ^iss. Calcis chlorid. bene tritur. gij. Axungise, ^x. M. In itch, morning and evening. Hospital. Linimentum Calcis Chloridum. Liniment of Chloride of Lime. 3t. Calcis chlorid. ^ss. Tere in mortario vitreo et sensim affunde Aq. rosar. (seu fontanae,) gj. Et post, limpid, clarificat. admisce 01. amygd. dulc. §j. To be applied by means of a pencil in cases of tinea capitis. Trusen. 110 new remedies. CALENDULA OFFICINALIS. Synonymes. Calendula Sativa, Caltha Sativa, Verrucaria, Crysanthemum, Sponsa Solis, Single Marigold, Garden Marigold. French. Souci, S. Ordinaire. German. Ringelblume. This plant belongs to the family Synanthereae, and in the Linnasan system to Syngenesia necessaria. It is much cultivated in the gardens of southern Europe more especially, and grows wild there. The whole plant has a feeble aromatic smell, which is not, however, unpleasant. The taste is bitter and somewhat pungent. It was examined chemically by Geiger and Stoltze,1 who found in it a peculiar glutinous matter, readily soluble in spirit of wine; insoluble in ether, and in ethereal or volatile oils, and but little soluble in water; to this they gave the name calenduline. EFFECTS ON THE ECONOMY. The term officinalis indicates, that the calendula was formerly received into the lists of the Materia Medica as an " officinal;" but it had become entirely obsolete, when Westring,2 a Swedish physi- cian, in 1817, recalled attention to it. He recommended it particu- larly in cases of cancer of the breast and uterus, having noticed its good effects by accident. Visiting an aged female, who had suffered, for a long time, under an extremely painful induration of one mamma, he found she was able to allay the burning pain by the application of the fresh plant. This induced him to try it in several cases of cancer, and from the results he was led to infer, that it is perhaps the best agent that can be employed in that frightful malady. He never, however, employed the calendula alone, but associated with it other active remedies, so that but little attention was, paid to his recommenda- tion ;—a great portion of the efficacy of the agents employed, being —it was thought probable—ascribable* to the associated articles. Some time after Westring's publication, the remedy was used by others, and his observations were confirmed. Rudolph3 employed 1 Berlin. Jahrb. d. Pharmac. B. xxi. S. 282. 2 Erfahrung iiber die Heilung der Krebsgeschwiire, u. s. w. Translated from the Swedish into German by K. Sprengel. Hal. 1817. s Hufeland und Osann's Jour, der prakt. Heilk. B. lviii. St. 1. S. 119. calendula officinalis. m it with advantage internally, in a case of induration of the mamma? in a young female ; but the acetate of iron was at the same time applied externally in solution. Fehr1 found it highly useful not only in incipient, but in advanced, scirrhus. Stein praises it in cancer of the integuments (hautkrebs). He forms the expressed juice of the young plant and flowers into an ointment with fresh butter, and applies it once or twice a day by means of lint, having previously washed the ulcers with a decoction of the plant. Inter- nally, the calendula is prescribed in the form of decoction, made with milk or water, or of a mellago prepared from the fresh juice, dissolved in an aromatic water; or made into pills. When the salve is applied, a sense of burning arises, which soon becomes absolute pain. This soon, however, abates; and almost wholly disappears,—if too violent, more butter may be added ; the ichorous discharge becomes improved; the offensive odour corrected, and in from fourteen to twenty-one days, the ulcer is converted into one of a benign and readily cicatrisable character. Rust also frequently administered the extractum calendulas in cancerous ulcers and as a discutient in chronic indurations, in combination, however, with other efficacious agents. Schneider affirms, that he prescribed the extract of calendula with the best effects in induration of the stomach, and in tumefaction and decided induration of the glands and uterus. A decoction of the flowers and plant, he employed in cancer of the uterus, and found it an excellent soothing, and discutient agent. Muhrbeck2 used the extract with eminent success in chronic vomiting; Carter3 in extremely obstinate vomiting; and De Camp in a case of cardialgia, where the excitability of the stomach was so great, that every remedial agent was rejected before it had opportunity to act. Fehr also extols it as an emmenagogue, for which property it was cele- brated with the older physicians. As Riecke4 has remarked, the amount of experience with the calendula is yet small—too small for us to pronounce whether it merits a fixed place in the lists of the materia medica. 1 Verhandlungen der verein. arztlich. Gesellschaft. der Schweiz. Jahrg. 1831, and Dierbach, in Heidelberger Annalen, B. x. H. 4. S. 501. Heidel- berg, 1834. * Hufeland's Journal der prakt. Heilk. B. lxii. St. 5, S. 128. Rust's Magazin. der gesammt. Heilk. B. xi. S. 350. 3 London Med. Rep. April, 1826, p. 347. See, also, Link and Osann, in art. Calendula in Encyc. Worterb. u. s. w. B. vi. S. 520. Berl. 1831. * Op. cit. S. 101. 112 NEW REMEDIES. METHOD OF ADMINISTERING. The extractum calendulas is contained in the Hannoverian and Saxon Pharmacopoeias; in the latter it is directed to be prepared in the following manner: Take of the calendula officinalis, 1 part. Water, 8 parts. Macerate for twenty-four hours; then boil for a quarter of an hour, and strain forcibly; boil the remainder with four parts of water; mix the two liquors, and, after twenty-four hours' rest, evaporate to the proper consistence.1 The dose of the extract is different according to different obser- vers. Muhrbeck gave four grains, five times a day. Fehr allows, 3ij. to 3vj. Phoebus directs the dose of the extract, prepared according to the Prussian Pharmacopoeia, to be eight to sixteen grains, gradually increasing it to 3ss. and more, from two to four times a day. It may be given either in the form of pill or mixture. Externally, the extract is used in solution, to moisten the dressings of ulcers, and to form ointments. The dose of the decoction of the fresh plant is gj. to gij. The Sardinian Pharmacopoeia has a cons erv a fiorum calendula, made by beating together one part of the flowers and two parts of powdered sugar. It has, also, an acetum fiorum calendula, made of one part of the petals digested in four parts of vinegar; and the Wirtemberg Pharmacopoeia has an unguentum fiorum calendula, made of four ounces of the petals boiled in a pound of fresh butter, until the mixture is entirely evaporated. This is used as an emol- lient and resolvent. Pilula Calendula. Pills of Calendula. i> Ferri oxydat. fuse. Herb, calend. pulv. Extract, calend. aa. £j. Mucilag. gum. arab. q. s. ut fiant pilulee xc. Dose.—Five to eight three times a day, as a soothing agent in cancerous ulcers. Rust. 1 Pharmacopee Universelle, &c. par Jourdan, ii. 536: CARBO ANIMALIS. 113 &. Hydrarg.submuriat.9ss. Sulphur, aur. antim. 9j. Extr. calendul. ---conii ruacul. aa. 9ij. M. f. pil. pond. gr. ij. Dose.—Five pills, three times a day, as a discutient in chronic indurations. Rust. Lotio Extracti Calendtda. Lotion of the Extract of Calendula. fy. Extract, calend. ----- cham. vulg. aa. gij. Solve in Aq. lauroceras. ^ij. Adde Tinct. opii simpl. 3j. As a wash (Verbandwasser) in cancerous ulcerations. Rust. It is obvious that the precise agency of the calendula cannot be tested in any of these formulas, the substances associated with it being themselves active agents. In this country, we do not believe it is ever used. CARBO ANIMALIS. Synonymes.—Carbo Carnis, Animal Charcoal. French.—Charbon animal. German.—Thierische Kohle ; Fleischkohle, Thierkohle. Animal charcoal is an ancient remedy, which has been revived amongst us. The older physicians used several kinds, and recom- mended them in various diseases, but without .having any fixed principle ; the circumstances, indeed, that suggested their exhibition in many cases, are entirely unintelligible to us of the present day. In the old Wirtemberg Pharmacopoeia, we find the Erinaceus com- bustus, or " burnt hedgehog," as an antihydropic ; the Sericum tos- tutn, or "burnt silk," and the Hirundines conibusta, or "burnt swallows," as antiepileptics; the Lepus combustus, or "burnt hare," as an antilithic ; the Reguli usli, or " burnt wrens," advised in nephritis and in calculous affections ; and the Talpa conibusta, or " burnt moles," at one time much extolled in erratic gout, lepra, scrofula, ulcers and fistulas ! All have properly fallen, however, 15 114 NEW REMEDIES. into oblivion with the profession, although there may yet be some, who cling with pertinacity to these relics of ancient ignorance and superstition. The cancer remedy of Cosme, into the composition of which burnt shoe soles entered, appears to have kept up the em- ployment of animal charcoal; aswellas the "burnt sponge," Spongia usta, in which, however, the charcoal is of but little efficacy com- pared with the iodine it contains. These were perhaps the only forms in which animal charcoal was used at the time when Weise, a German physician, revived its employment; and many physicians soon came forward to attest favourably in regard to it. METHOD OF PREPARING. Weise gives the following method of preparing it. Cut ribs of veal, with the flesh attached, into small pieces, and put them in a drum for roasting coffee,—turning the drum constantly whilst it is placed over the fire. When inflammable air begins to pass off, which is distinguished by the flame playing around the drum, the combustion must still be kept up a quarter of an hour longer. If it be continued so long as any inflammable air is disengaged, the preparation is inefficacious. The substance, most commonly met with under the name of animal charcoal, is obtained by burning bones. The residue, when reduced to powder, is the well known substance bone black or ivory black} This generally contains more or less phosphate of lime according to the kind of bone from which it has been procured. This is directed in the London Phar- macopoeia to be purified by digestion in dilute hydrochloric acid as follows : " Take of animal charcoal, a pound; hydrochloric acid and water, each twelve fluid ounces. Mix the hydrochloric acid with the water, and gradually pour it upon the charcoal; then digest for two days in a gentle heat, occasionally agitating. Set aside, and pour off the supernatant liquor ; then wash the charcoal with repeated portions of water, till no traces of acid are perceptible ; lastly, dry it."2 Charcoal, prepared in this way, should be a com- bination of carbon, carbonate and phosphate of lime, hydrogen, and azote. From an analysis, which Meurer made of animal charcoal, prepared according to Weise's formula, it contains also muriate and a little carbonate of soda, as well as a portion of iron. 1 See Art. Carbo Animalis, by Dr. F. Bache, in Wood and Bache's Dis- pensatory, 3d edition, p. 161. 2 Brande, Dictionary of Materia Medica, p. 151. London, 1839. CARBO ANIMALIS. 115 EFFECTS ON THE ECONOMY. In the case of a young man of scrofulous diathesis, Weise saw a tumour, of the size of a hazelnut, and very painful, situate under the nipple, disappear under the use of animal charcoal. According to him, its efficacy is strongly exerted on the uterus and mammae. Rothamel and Hohnbaum extol it in dyspepsia and gastricism, as well as in cases of diarrhoea. In obstinate chronic glandular indurations, especially of the mammary glands, Weise affirms it to be a certain remedy; he, at the same time, however, considers a regulated diet to be indispensable. Scirrhus of the lips, he says, also disappears under its use, and even scirrhous goitre when the charcoal is associated with burnt sponge. On cartilaginous polypi, it is said to have exerted a beneficial agency, and to have diminished the tendency of mucous polypi to return after operation. Even open cancer, it is asserted, has been healed by it.1 On these recommendations of Weise, animal charcoal has been used by several German physicians, especially by Wagner, Kopp, Pitschaft, Radius, Rothamel, Hesselbach, Gumpert, Hohn- baum, Fricke, Michaelsen, and Siebenhaar; and as a general re- sult of their observations it would seem not to be devoid of thera- peutical agency; although many of the experimenters failed in noticing any sanative effect from it. Fricke, for example, did not observe the least benefit in the very cases mentioned by Weise. He gave it also in the way of experiment, in several other cases, but without detecting the slightest influence on the organism. Other physicians saw advantages from its use in open cancer, but these were only transient. On the other hand, the experience of Wagner, Kopp, Michaelsen, and Rothamel would seem to show, that it was effectual in removing incipient scirrhus of the mammas. Kopp employed it successfully in scirrhous goitre, and Pitschaft in a case of what he terms struma varicosa. Radius dispersed under its use a considerable swelling of the submaxillary glands. In scrofulous affections, especially in scrofulous indurations of the glands, it proved useful in the hands of Kopp, Rothamel and Speranza. Pitschaft, in a delicate, strumous woman, who was suffering constantly under ozasna, found it of eminent service after other remedies had failed. Radius thought it aided the absorption of a disintegrated cataract, and Siebenhaar saw good effects from it in induration of the pancreas. 1 Riecke, Die neuern Arzneimittel, u. s. w. S. 104 116 NEW REMEDIES. Riecke1 suggests, that further trials might show that it might be used in the place of iodine, which it appears to resemble in its action on the economy, whilst it affects the organism less in- juriously. It is extremely doubtful, however, whether the proper- ties of the two substances can be regarded as at all analogous, and whether the charcoal is possessed of any other properties than those usually ascribed to the prepared charcoal. MODE OF ADMINISTERING. The carbo animalis is given in doses of from half a grain to three grains twice a day, commonly in the form of powder with sugar, or with powdered liquorice root. Weise advises it to be sprinkled on the hard edges of cancerous ulcers, and Speranza extols an ointment made of charcoal and oil or simple cerate as a discutient in scrofulous swellings. Pulvis Carbonis Animalis. Powder of Animal Charcoal. £. Carbon, animal, gr. ij. Pulv. rad. glycyrr. gr. v. F. pulvis. A powder to be given morning and evening. £. Carbon, animal, gr. vi. Spong. marin. ust. gr. xij. Pulv. rad. glycyrrhiz. gss. M. F. pulv. in partes vi a?quales dividendus. A powder to be taken night and morning in scirrhous goitre. Riecke. gf. Pulv. carbonis animal, gr. iv. Pulv. rad. glycyrrh. 9iv. M. et divide in part. viij. One of these to be taken dry, morning and evening, a little water being drunk afterwards, in cases of scirrhous indurations of the mammas. After the eight powders have been taken, the dose may be increased gradually by half a grain, until it ultimately attains four grains. At the same time, abirritating and spare diet should be inculcated. 1 Op. cit. CAREONIS SESQUI-IODIDUM. 117 Boli Carbonis Animalis. Boluses of Animal Charcoal. 8t. Pulv. carbon, animal, gr. iij. Ammon. muriat. pulv. 9j. Ext. conii macul. gr. ij. ---glycyrrhiz. q. s. ut fiat bolus. One of these to be given three times a day;—in cases of swell- ing and scirrhus of the prostate, and of the mucous membrane of the urethra. Magendie. CARBONIS SESQUI-IODIDUM. Synonymes. Carbonis Sesqui-ioduretum, Sesqui-iodide or Sesqui-ioduret of Carbon. This preparation is made by mixing concentrated alcoholic solu- tions of iodine and potassa until the former loses its colour. A solution is obtained, from which the addition of water will throw down a yellow precipitate—the sesqui-iodide of carbon. This substance is soluble in alcohol and ether, but insoluble in water. The ethereal solution yields large yellow crystals by slow evaporation. It has a sweet taste, and a strong saffron-like odour. Mitscherlich1 considers the taste very disagreeable. Fifty grains given by Dr. Cogswell,2 to a strongly made terrier dog, proved fatal; and, on dissection, the large vessels were found congested; the inner membrane was closely corrugated, and the apices of the rugae were of a rose red colour. effects on the economy in disease. Dr. Litchfield3 used it with advantage in five cases of enlarged glands; in two of lepra, and three of porrigo, in the form of oint- ment composed of 5ss of the powder to 3vj of simple cerate. 1 Traite de Chimie, traduit par Valerius. 2 Essay on Iodine, p. 122. Edinb. 1837. 3 Lond. Med. Gaz. Aug. 1836. 118 NEW remedies CETRARINA. Synonymes. Cetraria, Cetrarine. French.—Cetrarin. This substance has been extracted, of late, from the lichen islandicus or cetraria islandica, by M. Herberger, a pharmacien at Kaiserslautern.1 METHOD OF PREPARING. The coarse powder of the lichen is boiled for half an hour in four times its weight of alcohol at .883; it is left at rest until vapours cease to be given off, to avoid the loss of the alcohol; it is then strained and pressed. Three drams of hydrochloric acid pre- viously diluted with water are now added to each pound of the lichen ; this is mixed with from four times and a quarter to four times and a half its bulk of water, and the mixture is left at rest for a night in a closed flask. The next day, the deep yellow fluid, which swims above the copious deposite obtained, is poured off: this deposite is the impure cetrarine, the colour of which is more or less greenish. It is now collected on a filter (chausse), left to drain as little as possible and subjected to pressure. To purify it, it must be divided into small fragments, and washed whilst still moist with alcohol or ether, which deprives it of colour ; it is then treated with two hundred times its weight of boiling alcohol, in which the inorganic matter, which has hitherto accompanied it, is scarcely soluble. The greater part of the cetrarine is gradually precipitated on the cooling of the alcoholic solution. The portion which still remains in solution, may be separated by the evapora- tion of the alcohol. Pure cetrarine is at times in the state of a white powder, resem- bling magnesia; at others in small globules united in the form of arborisations, which do not present—even under the microscope— any crystalline texture. When gently compressed, it has a slight silky splendour. It is light, unalterable in the air, inodorous, and has a very intense bitter taste, especially in the alcoholic solution. Its best solvent is absolute alcohol, one hundred parts dissolving 1.70 of it at the boiling temperature, but only 0.28 at 14° centig. 1 Buchner's Repertorium, B. viii. H. 1. 1837. CETRARINA. 119 (58° Fahr.) Alcohol, at 0.830 dissolves 0.44 when boiling, 0.28 at 25° cent. (77° Fahr.) and only 0.04 at 14° cent. (58° Fahr.) It is still less soluble in boiling and in cold water, the essential oils, creosote, &c. It is somewhat more soluble in ether, but insoluble in the fixed oils.1 EFFECTS ON THE ECONOMY IN DISEASE. M. Muller, a physician of Kaiserslautern,2 details two cases in which he has administered the cetrarine. One of these was a quartan, the other a tertian intermittent. The effects appeared to be exerted more slowly than those of quinine, but it seemed to him not to affect the stomach as much.[?] Its price must be much less, as M. Herberger succeeded in obtaining from a pound of lichen 135 grains of very pure cetrarine. It has not been given, so far as we know, in this country. METHOD OF ADMINISTERING. Muller gave it in the form of powder according to the following prescription :— 3<; Cetrarin. Gummi arabic. aa. gr. ij. Sacchar. alb. 9ss. M. et fiat pulvis. Dose.—One of these every two hours during the apyrexia. H. Brack,3 suggests, that if dissolved in spirit of wine, its action may be incomparably more potent, and that it may more speedily arrest the paroxysms of an intermittent than when given in powder. 1 Journal de [Pharmacie, xxiii, 505, Paris, 1837, and Bulletin General de Therapeutique, No. 18, Sep. 30, 1837. 2 H. Bruck, in Bulletin General de Therapeutique, No. 17. Sep. 15,1837. 3 Op. cit. 120 NEW REMEDIES. CHIMAPHILA (FOLIA.) Synonymes. Chimaphilse vel Chimophilae Umbellatse Folia; Pyrolae Um- bellatse Folia, Winter Green, Pipsissewa. French.—Herbe a pisser, Pyrole en Ombelle. German.—Die Blatter des holdenbluhtigen Wintergruns. This plant is not new to us; but numerous trials have been made with it recently in Europe. It is admitted into the Pharma- copoeia of the United States, is a beautiful evergreen, and is indi- genous in the northern parts of Europe, Asia, and America. It belongs to the natural family of heaths, Ericeae; and, in the Lin- nsean System, to Decandria Monogynia. A good description of it is given by Barton.1 The leaves have a bitter-sweetish taste, with some degree of astringency. The taste of the stems and roots is, in addition, con- siderably pungent. Boiling water and alcohol extract the virtues of the plant. The constituents, so far as ascertained, are bitter ex- tractive, tannin, resin, gum, lignin and saline matters. EFFECTS ON THE ECONOMY IN DISEASE. The leaves of the Chimaphila were long used by the Indians of this continent, and from them the American physician was induced to employ them. The first regular treatise respecting the plant is said to have been a thesis of Dr. Mitchell, published in the year 1803.2 In Canada it is said to have been long used in diseases of the urinary passages, especially in calculus, dropsy, and in chronic gout and rheumatism; its effects appearing to resemble—but not to exceed—those of the uva ursi. Somerville3 and Barton extol it as an excellent diuretic in different forms of dysuria, and in drop- sies, especially such as succeed to acute diseases ; in nephralgia as a palliative, especially when the paroxysms are occasioned by gravel which has accumulated in the kidney ; and even in vesical calculus. During its use the appetite improved, and the digestive powers augmented; the patients often experiencing—immediately after it was taken—an agreeable sensation in the stomach, and in the region of the kidneys. 1 Medical Botany, i, 17; see, also, Art. Chimaphila, in Wood & Bache's Dispensatory, 3d edit. p. 193. 2 Barton's Collection, ii, 2. 3 Medico-chirurgical Transactions, v, 340. CHIMAPHILA. 121 Radius1 found it especially serviceable in dropsy, gout and rheu- matism ; and in inordinate activity of the secretory function of the mucous membranes—chronic catarrh, phthisis pituitosa, &c. Ac- cording to him, it is contraindicated where there is much fever, disposition to diarrhoea, gastricisrn, and great debility of the stomach. Heyfelder affirms, that the chimaphila appears to be advantageous in the debility of the digestive organs attendant upon dropsy, but its diuretic effect is not considerable or enduring, so that it requires to be associated with other more powerful agents. Experiments, which have been made recently in the Biirgerhos- pital at Pesth, and which have been collected by St. Rochus and published by Windisch, the director of the hospital, are extremely favourable to the chimaphila. Within two years, nearly two hun- dred dropsical cases are said to have been radically cured by it. Windisch recommends it most strongly to the attention of his col- leagues ; he asserts it to be one of the best diuretics we possess; that it does not impair digestion ; moderately accelerates the circu- lation ; gently encourages the action of the bowels, and powerfully augments the urinary secretion; that the patients willingly take it, and that it induces no nausea. It was administered with advantage in dropsies unaccompanied by fever, and not dependent upon or- ganic mischief, upon "corruption of the humours or paralysis of the lymphatic textures." In febrile conditions and inflammatory diatheses, it is said to have been always injurious, as well as when it was administered prior to the resolution of obstructions remaining after long protracted intermittents ; but when these are removed, and no excitement exists, more, according to Windisch, is to be expected from it than from any other agent, and he strongly ad- vises, that careful trials should be made with it in the proper cases. He advises, also, that its use should be persevered in, in order that good effects may be derived from it. We have frequently administered the chimaphila in public and private practice, and have found it serviceable, where a tonico- diuretic was indicated. MODE OF ADMINISTERING. The chimaphila is given either in infusion, or, what is preferable, in decoction ; the dose in the day being from half an ounce to an 1 Auserlesene Heilformeln zum Gebrauche fur praktische Aerzle und Wund&rzte, u. s. \v. Leipz. 1836. 16 122 NEW REMEDIES. ounce. Where it does not act sufficiently on the bowels, Radius advises, that a few senna leaves should be added. In affections of the chest, he found the addition of the sweet spirit of nitre advan- tageous. Generally, however, he gave the chimaphila alone. Windisch found a combination of it with tartar emetic, liver of sul- phur, sal ammoniac, squill, and, in very great weakness, cinchona and preparations of iron, serviceable. Radius often administered also the aqueous or spirituous extract. Decoctum Chimaphila. Decoction of Chimaphila. fy. Chimaphil.umbellat. 3j. Macera per horas xij. in aquae font. Bij. (ffiiss Ph. Lond.) Coque ad colatur. B5j. To be used daily in dropsy. Somerville. 3<. Chimaphil. umbellat. ^ss ad §j. Coque cum aquae font. §xij, ad reman, ^vj. Coctione finita adde Spiritus frumenti. (gin, malt spirit or whisky) ^ij. Digere frigide per horas vj, et cola. Dose—Two spoonfuls to be taken four times a day in dropsy and gout. Radius. &. Chimaphil. umbellat. gvj. Coque cum aq. font, ^xij ad reman. § vj. Sub finem coctionis adde Fol. sennse gij, et cola. Dose—A spoonful to be taken every two hours. Radius. CHLORINUM. Synonymes. Chlorum, Chlorine, Murigene, Acidum Muriaticum Oxygena- tum, Acidum Marinum Dephlogisticatum, Spiritus Salis Marini Dephlo- gisticatus. French.—Chlore. German.—Chlor, Chlorgas. Uncombined chlorine is employed medicinally not only in the gaseous but liquid state. Of each of these we shall treat in suc- cession. CHLORINUM. 123 The forms for evolving it in the gaseous state, as well as the gaseous chlorine itself, have had various names assigned them ex- pressive of their chemical or medical properties. They have been termed, respectively, Acidum muriaticum oxygenatum ad contagia ; Fumigatio muriatico-oxygenata; Pulvis ad fumigationes muriati- cus ; Species pro vaporibus superoxydi muriatici; Suffitus oxymu- riaticus; S. chlorini; Alexiterium Chloricum, Fumigation de chlor, F. de Guyton, F. Guytonienne, F. Hygienique, &c. MODE OF PREPARING. Chlorine is obtained from muriatic or hydrochloric acid. For this purpose, one part of well pulverised peroxide of manganese with five or six parts of concentrated muriatic acid is put into a retort, to which heat is applied and the gas received over water. Or, it may be obtained from a mixture of one part of manganese four parts of kitchen salt, two parts of concentrated sulphuric acid, and four parts of water. Chlorine is a greenish yellow gas; of a peculiar, strong, disa- greeable, stifling odour. The flame of a lighted taper introduced into it becomes at first pale, afterwards red, and is ultimately ex- tinguished. It remains unchanged in the highest temperatures. It has a great affinity for hydrogen, so that it abstracts this gas from every substance that contains it, and forms with it muriatic acid. Hence it decomposes all the gases that contain hydrogen, and all organic colouring matters, as well as—it is conceived by many—miasmata and contagious matters. EFFECTS ON THE ECONOMY. Chlorine when diluted, and received into the lungs, occasions coughing, and symptoms of suffocation, to which a protracted catarrh often succeeds ; not unfrequently, too, we observe in those, who are compelled to be exposed to the gas, bronchitis and pneu- monia. Animals soon die when they are immersed in it.1 In Mr. Broughton's experiments, mice exposed to it fell dead in less than thirty seconds. On opening them, the heart was found palpitating ; the peristaltic motion of the intestinal canal con- tinued, and could be kept up by irritating it with a probe. The vessels of the brain were collapsed. The lungs were tinged with 1 See Christison on Poisons, 3d edit. p. 736. Edinb. 1836. 121 NEW REMEDIES. the yellow colour of the gas, and the peculiar odour of chlorine was perceptible throughout their structure. Coagulation of the blood took place as under ordinary circumstances. A rabbit, two or three weeks old, was immersed in chlorine, and died in less than half a minute. On opening the thorax, the heart was found acting freely and on puncturing the aorta, the blood jetted out forcibly to a considerable distance. The peristaltic motion of the bowels was also going on. The vessels of the brain were in a collapsed state. The lungs were very much distended, tinged yellow, and when removed from the chest to a distance, emitted the odour of chlorine. The right ventricle of the heart was distended with dark blood. The eyes were much glazed in each experiment. " It has been generally thought," adds Mr. Broughton, " that chlorine is incapable of passing the epiglottis" (the glottis), "but from the above observations it is evident that this gas enters the bronchial tubes in the act of inspiration. A portion of it probably circulates through the brain, suspending the cerebral functions without di- rectly destroying the action of the involuntary organs,—contrac- tility remaining long after the destruction of animal life, as is evinced by the activity of the heart and of the intestinal canal."1 These very facts, however, seem to show that but little of the gas enters the lungs; probably no more than what passes imme- diately preceding the closure of the glottis by the forcible contrac- tion of the arytenoidei muscles. When inhaled in a dilute state, it is absorbed, and, according to Mr. Wallace, the urine acquires bleaching properties. It would appear also, that, in manufactories, the chief consequences, resulting from exposure to an atmosphere of chlorine, are acidity and other stomach complaints, which the men generally remove by taking chalk:2 this fact is confirmatory of the view, that acidity of the stomach is usually, if not always, dependent upon excess in the secretion of the gastric acids, the most important of which is the hydrochloric. Where chlorine is inhaled, it is reasonable to suppose that more of the hydrochloric acid may be secreted in the stomach. METHOD OF EMPLOYING. 1. By inhalation.—In the way of inhalation, chlorine gas is never administered in a state of purity, but always diluted with 1 Journal of the Royal Institution, from Jan. to June, 1830. 8 Pereira, Elements of Materia Medica, pt. i. p. 107. Lond. 1839. CHLORINUM. 125 atmospheric air; often, too, it is united with watery vapour. Gannal affirms that the workmen in a bleaching establishment, who suffered under diseases of the chest, were visibly improved, and ascribed the amelioration to the inhalation of air containing chlorine. He, therefore, instituted various experiments on con- sumptive individuals, from which good results, he conceived, fol- lowed. Sir James Murray1 also mentions that a friend of his had observed similar effects among his workmen exposed to the inhala- tion of watery vapour strongly impregnated with chlorine. The experiments, however, which were instituted at La Charite, in Paris, on this mode of treating phthisis, were by no means en- couraging; and the same may be said of those at the Hotel Dieu of that city, instituted by Rullier.2 In many cases, indeed, the disease appeared to be aggravated. Bayle likewise thought the inhalation of chlorine generally un- favourable, although he asserts that he cured a case of tubercular phthisis thereby. Recently, it has been again recommended by Cottereau. Professor Albers,3 of Bonn, who administered it repeatedly, and carefully watched its effects, conceives that it acts as a stimulant when applied to the membrane, but that, when it gets into the blood, its effects are antiphlogistic ; and he is of opinion that, when there is no haemoptysis, or violent local irritation present, chlorine inhalations may be used in diseases of the lungs and air passages. Its stimulant effect gradually diminishes, and, after a time, the mucous surfaces of the lung become less sensible to its exciting influence. In tubercles of the lung, in chronic catarrh, in chronic inflammation and ulceration of the bronchial mucous membrane, and in dilatation of the bronchi, he found it of no service, and, in most cases, it could not be borne in consequence of the irritation it induced ; but its operation was very salutary in pure ulceration of the lungs or vomica. It had always, however, to be administered cautiously and experimentally. Dr. Stokes always found chlorine inhalations prejudicial in phthisis, producing, in every case, increase of bronchial irritation, 1 A Dissertation on the Influence of Heat, &c, Lond. 1829; cited in the Dublin Journal of Medical Science, for March 1839, p. 96. 2 See, also, Pereira, Elements of the Materia Medica, pt. i. p. 108. Lond. 1839. 3 Hannoversche Annalen, 1836, and Br. and For. Rev. for July, 1837, p. 215. 120 NEW REMEDIES. dyspepsia, and arrest of the pulmonary secretion. In his trials of the remedy in gangrene of the lungs,1 he found it decidedly bene- ficial, correcting the foetor of the breath and expectoration, and, therefore, calculated to obviate not only the local but the constitu- tional symptoms. Sir James Clark2 is of opinion that the inhalation of chlorine has only produced relief in persons whose lungs have been dis- eased to a very limited extent. Dr. Pancoast informs the author, that a case of aphonia, occur- ring in a young lady, in which there was but little voluntary power over the diaphragm, was cured by the inhalation of chlorine, after the galvanic plates and the electro-magnetic apparatus had been used in vain. The chlorine may be inhaled from a common dish or inhaling apparatus, by dropping any of the acids on a mixture of chloride of lime, so that the acid may be disengaged slowly, but the best method of inhaling it, as well as iodine, is that recently recom- mended by Dr. Corrigan.3 He properly remarks that, in order that inhalation may have a fair trial, it is requisite, first, That the apparatus should be simple in its construction, and easily kept in order. Secondly, That it should be capable of keeping up a sup- ply of vapour for any length of time, and that the evolution of the vapour should be steady and easily regulated. Thirdly, That it should also furnish a sufficient supply of aqueous vapour to prevent any irritation of the larynx, or lining membrane of the air tubes ; and, fourthly, and most important of all, that its employment should entail neither trouble nor fatigue on the invalid. To fulfil these objects, Dr. Corrigan advises^the apparatus repre- sented in the following page. It consists of a light open iron-wire frame, about eighteen inches high, at the bottom of which is a spirit lamp, A: at the proper height above it is an evaporating porcelain dish, about six inches in diameter, B: above this is a glass globe, C, with its neck downwards. In the neck of the globe is a cork, D, bored, and through the opening is drawn, moderately tight, a short plug of cotton wick, such as is used in a spirit lamp: in the glass globe at E, opposite the neck, is drilled a pin-hole, to allow air to pass in, according as the fluid within 1 Dublin Hospital Reports, vol. v. 2 Treatise on Tubercular Phthisis, p. 84, Lond. 1834; also, Amer. edit. Philad. 1835. 3 Dublin Journal of Medical Science, March, 1839, p. 94. CHLORINUM. 127 drops out through the neck. To use it. the porcelain dish is filled with hot water, the spirit lamp is lighted, and as soon as the water in the dish has begun to boil, the glass globe containing the chlo- rine, (if this be the substance used,) is placed as shown in the mar- ginal illustration. The rate, at which the fluid in the globe shall percolate the cotton wick and drop into the hot water beneath, is easily regulated. If it does not drop with sufficient rapidity, one or two of the threads of the cotton may be removed. If it drops too rapidly, this is corrected by pressing in the cork more tightly, or introducing one or two additional threads of wick. In employing the chlorine, eight ounces of saturated solution of chloride of lime may be poured into the glass globe ; and into the water of the porcelain dish, two ounces of the dilute sulphuric acid of the pharmacopoeia. As the solution of the chloride drops, the acid seizes on the lime, and the chlorine is evolved in connection with aqueous vapour.1 Chlorine is but little used in this form, and can only be adapted for cases in which the pathological condition of the bronchial mucous membrane, or neighbouring parts, requires the exhibition of an ex- citant.2 In this way, it may be occasionally serviceable in chronic 1 Lond. Med. Gazette, April 6, 1839, p. 49. 2 Toulmouche, in Revue Medicale, Avril, 1834. 128 NEW REMEDIES. bronchitis ; but its administration requires great caution.1 In cases of poisoning by the hydrocyanic acid, as well as by sulphuretted hydrogen, chlorine is a most efficacious agent. The chloride of lime may be used for this purpose. 2. By Fumigation.—Fumigations of chlorine have been parti- cularly recommended by Wallace, of Dublin.2 They appear to resemble, in their action, the nitrous and nitro-muriatic acid baths, and have been especially employed in liver diseases, unaccom- panied by inflammation, but in which there is disturbance of the biliary secretion. According to Wallace, fumigations of chlorine are more certain than ablutions and baths of nilro-muriatic acid, and they have the advantage, that their application subjects the pa- tient to less inconvenience. The good effects of chlorine, in such cases, have likewise been tested by Zeise,3 in his bathing establish- ment at Altona. When the chlorine is, in this way, brought into contact with the skin, it soon occasions a pricking sensation ; in- crease of transpiration ; great afflux of fluids to the surface of the body, and sometimes a pustular eruption; increased secretion of saliva, urine, and bile; slight inflammation of the mouth and fauces, and impeded respiration and circulation. Wallace found chlorine fumigations serviceable not only in hepatic diseases with disordered secretion of the liver, but in several other morbid conditions, as hypochondriasis, cachexia, and in all affections in which a prolonged excitation of the skin, and a resto- ration of its suppressed or impaired functions could be esteemed serviceable,—hence, in old cases of syphilis, scrofula, chronic ca- tarrh, and rheumatism : generally, cathartics were combined with the fumigations, and the evacuations were constantly observed to present a highly bilious character. In chronic cutaneous affections, as in lepra, psoriasis, and sca- bies, these fumigations have been found useful; but, generally, fumigations of sulphurous acid are employed by preference, in con- sequence of the greater facility with which they can be prepared.4 Injections of chlorine gas have been employed for the radical cure of hydrocele by M. Deblois, of Tournay, and M. Deconde.5 1 Archives Generales, Avril, 1834; and a recent communication on the excellent effects of chlorine vapour incatairh, in Gazette Medicale de Paris, June, 1838. 2 Researches respecting the Medical Powers of Chlorine, &c. Lond. J822. 3 Nye Hygea udgived af C. Otto, 1825, and Hufeland und Osann's Journ. der prakt. Heilkund. B. Ixiii. St. 1. 4 Green on Diseases of the Skin. American Library edit., Philada. 1838. 6 Bulletin Medical Beige, Janvier, 1836. CHLORINUM. 129 The chlorine gas is contained in a bladder, to which is attached a pipe and stopcock adapted to the canula of the trocar, into which it is fixed after the fluid is evacuated: the stopcock is then turned, and the bladder pressed so as to force the gas into the tunica vagi- nalis. When this is distended, the pipe and bladder are removed, and the thumb is placed over the mouth of the trocar, so as to pre- vent the issue of the gas for the space of two minutes: it is then allowed to escape, and two or three repetitions of the injection are made, which are sufficient for the cure. It would appear, that risk must be incurred from the injection of such an acrid substance, but M. Deconde says not. Fumigations of chlorine, with the view of destroying the matter of contagion, and of preventing the spread of contagious diseases, have long been used.1 As long ago as the year 1773, they were proposed by Guyton de Morveau, and hence they have been called the "Guytonian," or the "Guyton Morveau fumigations." They are the best agents for the purpose that we possess. In fumigating the extensive general penitentiary at Milbank, Westminster, Dr. Faraday adopted the following method. One part of common salt was intimately mixed with one part of the black oxide of manganese; the mixture was placed in a shallow earthen pan, and two parts of oil of vitriol, previously diluted with two parts by measure of water, were poured upon it,—the whole being stirred with a stick. Chlorine was liberated for four days. The quantities of the ingredients employed were 700 pounds of common salt, the same quantity of the oxide of manganese, and 1400 pounds of sulphuric acid.2 When chlorine is evolved in the manner described, it is liable, like all the acid gases, to the objection that it is extremely irritating when respired. It cannot, therefore, be used in the sleeping apart- ments of the sick, although it may be employed beneficially after they have been withdrawn, and the object is to disinfect the cham- ber. It ruins all polished surfaces, but this can be effectually ob- viated by painting them over with a compost of starch. The chlo- rides are not liable to the same objection, as they exhale the chlorine slowly.3 1 Link, Art. Chlor, in Encyclopad. Worterb. der medicin. Wissenschaft. B. vii. S. 575. Berlin, 1831. 2 Pereira, Op. cit. p. 107. 3 See the author's General Therapeutics, p. 509. Philad. 1836. 17 130 NEW REMEDIES. CHLORINI AQJJA. Synonymes. Aqua Chlorinii, Liquor Chlori, Aqua Chlori, Aqua Oxymu- riatica, Liquor Acidi Muriatici Oxygenati, Aqua Oxygenata Muriatica, Aqua Oxygeno-Muriatica, Liquor Alexitereus Oxygenatus, Solutio Alexi- teria Oxygenata, Solution of Chlorine, Liquid Oxymuriatic Acid. French.—Chlore Liquide, Eau de Chlore. German.—Chlorwasser. This preparation is contained in many of the pharmacopoeias. It is in those of Austria and An vers ; and in the Batavian, Bavarian, Belgian, Danish, Dublin, Parisian, Finnish, Hannoverian, Polish, Prussian, and Swedish.1 It has been more extensively adminis- tered on the continent of Europe than in this country, or in Great Britain. METHOD OF PREPARING. The Prussian Pharmacopoeia directs chlorine gas, made after the manner before described, to be passed into the bottles of a Woulfe's apparatus filled with distilled water, until two-thirds of the water are displaced ; the bottles are corked under water, and the water is agitated until it takes up the gas. The liquid is then drawn off into small bottles, which are well filled, and kept in a dark place. In this way, liquid chlorine may be kept for a long time undecomposed. In its preparation, some little muriatic acid is formed, so that it has at times to be purified by treating it with a solution of nitrate of silver. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made by Orfila2 on dogs, it appears that con- siderable doses of a moderately concentrated solution of chlorine prove fatal, by exciting sooner or later inflammation of the stomach, accompanied with great languor; and when death takes place very rapidly, signs of organic alteration are met with in the stomach. In its action on the economy, chlorine is closely allied to the acids, and especially to the muriatic. Introduced into the stomach in moderate doses, the solution of chlorine excites an agreeable feeling of warmth, which soon spreads over the whole of the body: in 1 Pharmacopee Universale, i. 405. Paris, 1828. 2 Toxicologie Generale, i. 141. CIILORINUM. 131 strong doses, according to L. W. Sachs, a kind of intoxicating stupor is induced by it, soon succeeded by prostration. It has been conceived to act equably as a moderate excitant on the nervous system, and thereby to moderate inordinate action in any part, and is, to a certain extent, antiphlogistic, without possessing any of the debilitating qualities of the antiphlogistics proper. In the opinion of some of the German pathologists, it exerts a powerful stimula- tion on the organic actions, especially on the lymphatic and glan- dular systems, moderating inordinate secretion. Its antiseptic pro- perties are likewise considerable. It would appear, however, that the number of observations has not been sufficiently great—al- though they have been by no means few—to allow of any com- prehensive appreciation of its exact modus operandi on the human organism.1 EFFECTS ON THE ECONOMY IN DISEASE. Although the solution of chlorine is properly no new remedy, it is only of late years, that it has been frequently administered. At the present day in some countries, it is in common use. It is not long since Meurer maintained, that it is impossible to administer chlorine internally, and that in every case in which it was believed to have been given, the article really taken was the hydrochloric or muriatic acid ; for, owing to the affinity of chlorine for hydrogen, whenever any union takes place between it and organic matters, the chlorine he affirmed disappears, and muriatic acid alone exists, as he had proved by repeated experiments. In this assertion, how- ever, he was opposed by many observers. Herzog and Barmann came forward with experiments to show that Meurer had gone too far in his deductions ; and from all the experiments, it would ap- pear, that in prescribing the aqua chlorini many mistakes had been, and—we may add—still are, committed. From Barwald's experi- ments it would appear, that if water which has rested on aromatic or other vegetable substances be chosen for the dilution of the aqua chlorini instead of distilled water, a difference is produced in the rapidity of the decomposition. In a mixture of aqua chlorini. distilled water, and simple syrup, the decomposition takes place tardily ; but if in the place of the syrup, a mucilaginous juice be substituted—for example, thesyrupus althaea?—acids are speedily formed ; as well as when a decoction of althaea is substituted for distilled water; 1 Riecke, Die neuern Arzneimittel, u. s. w. S. 30. Stuttgart, 1837. 132 NEW REMEDIES. whereas a mixture of the decoction of salep (gr. v to water gj), syrup, and the aqua chlorini in well stopped bottles remained undecomposed above twenty-four hours. In these experiments, however, the persistence of the smell and taste of the chlorine ex- hibited, that the whole of the chlorine had not been converted into muriatic acid. In the same manner as in the case of the decoction of marshmallows, the addition of the infusum sennae and infusum Valerianae, as well as of solutions of extracts, and especially of liquorice, destroyed the smell of the aqua chlorini instantaneously, even when the taste of chlorine could still be detected. When the solution was combined with remedial agents, that contain much colouring matter, the decompostion took place with great rapidity. From the results of these experiments, Barwald advises the aqua chlorini to be given in admixture with distilled water and simple syrup, as in this way only can we be sure, that the patient has taken the chlorine undecomposed. Herzog lays it down as a rule, that the solution of chlorine should only be mixed with colourless transparent substances—water, simple syrup, gum arabic or the decoction of salep. In respect to its administration in disease, we shall speak first of its internal use, which in several morbid conditions seems to have rendered good, and in some cases eminent, service. The following are the diseases in which it has been chiefly recommended. 1. Irritative fever, as in the violent irritative fever that occurs during the period of dentition ; in which it has been administered with great success by Kopp, Mehlhausen, Goden, Trusen, and Riecke.1 Dangerous determinations to the head have been, in this way obviated, along with the unpleasant complications which are apt to be occasioned thereby. Toel2 exhibited it in convulsions, during dentition, which were accompanied by too great activity of vessels, and he affirms, that he has prescribed no remedy, which, in all respects, answered so well. 2. Nervous fever, especially when tending to the putrid charac- ter. In the plague, according to Wagner, it is of no avail; but in putrid fever, according to Kopp, it is highly useful. Spangenberg observed good effects from it in an epidemic typhus with hepatic derangement. It is likewise extolled in typhus by Wolf, Braun, Hufeland, and others ; and by Sacco in the fever called petechial, itself a typhus. Of late, it has been much used in Germany in 1 Op. cit. S. 30. 2 Archiv. d. med. Erfahrung, Marz und April, 1825. CHLORINUM. 133 the typhus abdominalis, which corresponds to our typhoid fever, to oppose the origin and development of the intestinal ulcerations; but when the disease is farther advanced it has been found useless. It is especially recommended in this disease by Clemens, but he commonly premises the use of an emetic. Trusen considers the emetic unnecessary. He first applies leeches to the epigastrium, and then prescribes immediately the aqua oxymuriatica in con- siderable doses ;—in lighter cases, a dram every two hours ; and if the disorder of the head be already great, the tongue chapped (rissig), and the peculiar expression of countenance present, he gives two drams every two hours. Bartels is less satisfied with the action of chlorine in abdominal typhus. It raises, he says, the sinking powers very speedily, but often excites the sanguiferous system, and not unfrequently increases the abdominal symptoms so palpably, that the physician is compelled to have recourse to other agents. Riecke1 thinks, however, that it may be of essential ser- vice in this disease, which so frequently mocks the best directed efforts of the practitioner; and he suggests, that farther experi- ments are highly desirable, especially as those instituted by Trusen and others are not free from objections, by reason of their having combined with the chlorine substances that quickly decompose it. 3. Carbunculus ?nalignus (M\\zbrandkarbim\;e\).—In the variety of malignant anthrax caused by handling the skins of cattle, the internal and external use of chlorine has been found of essential service by Ettmuller, Herbst, Stumpf, and Hoffmann. 4. Scarlatina.—Pfeufer, Wendt, Kopp, and Trusen extol it highly in this disease, for which, on theoretical grounds, it would seem to be appropriate, by reason of the great turmoil in the san- guiferous system, as indicated by rapidity of pulse and inordinate secretion of heat, bearing but little direct ratio to the degree of vital energy. Braith waite, who, it is asserted, was one of the earliest, if not the earliest, who advised chlorine in scarlatina, supposed that it acted as specifically as the bark in intermittent, or mercury in syphilis ; and Trusen asserts that it may be advantageously used in cases where other remedies have been found ineffectual. It is espe- cially recommended by Braun and Spiritus in malignant scarlatina. 5. In other febrile exanthemata, small-pox, measles, rubeola, &c, it has been prescribed with advantage. In putrid dysentery, (faulige Ruhr,) it is extolled by Nysten and Kopp; and in inter- mittent, by Kopp and Kretschmar. Trusen recommends it 1 Op. cit. S. 33. 134 NEW REMEDIES. in the irregular, and especially in the anticipating forms, where there is danger of their becoming continued. Under its use, he found the paroxysms became regular, with perfect apyrexiae, so that the ordinary febrifuges could be advantageously given. In gastric fever, Trusen trusted to it solely for the removal of the dis- ease: he found that it corrected the morbid secretions from the mucous membrane of the digestive tube. Other physicians have also derived equally favourable results from its administration in that disease. 6. In gastromalacia, it has been prescribed by Rhades, Blasius, and Winter, but as Riecke,1 from whom this detail of the experi- ence of the German practitioners has been chiefly taken, properly observes, farther observation is necessary before we can decide as to its efficacy in such cases. 7. In erysipelas, especially of children, it has been recommended by Kopp. 8. In inflammation of the liver, favourable result? were obtained from it in the Children's Hospital of St. Petersburg; and it exhibited, in these cases, the analogy to calomel in its action, which has been pointed out by many observers. 9. In hydrophobia, it has been used both internally and exter- nally as a preventive, especially by the Italian physicians Brera, Previtali,2 Ghisaldoni, Agliati, Arrigoni, Narcisi, and Anelli, whose experience is in its favour. Wendelstadt and Ruppius have like- wise published favourably regarding it. It is obvious, however, that much fallacy may arise as to the precise agency of reputed preventives. Every one, for example, who may be bitten by a mad dog is not attacked with hydrophobia; and, unless great caution be used, any article may be regarded as a preventive. This is the main reason why we have so many preventives of hydrophobia and other diseases. 10. Again :—the solution of chlorine has been advised by Rup- pius and Mertzdorf in dropsy, especially such as supervenes on the acute exanthemata. 11. In the diathesis phthisica, it has been recommended by Gbden, and has been affirmed to moderate the hectic in phthisis, and to make the remissions more marked. In these cases, it re- quires to be given in large doses, and to be exhibited for a consi- derable time. 1 Op. cit. S. 34. 2 Pratiche Osservazioni sull Idrofobia, &c. Milan, 1820. CHLORINUM. 135 12. In many cases of chronic cutaneous affections, with dimi- nished plastic energy, it has been used with success by Kopp. 13. Lastly : in noma, or cancrum oris, and in foetor of the mouth, it has been recommended internally as well as topically ; and, ac- cording to the experiments of Persoz, Nonat, and others, it renders eminent service in cases of poisoning by the hydrocyanic acid. Externally, it is used either pure, diluted with water, or in com- bination with oil. Godier affirms that he cured strumous swellings of the glands by a cerate of chlorine. Eisenmann, Cullerier, and Blache recommend it at times pure, at others diluted, in the way of injection, in gonorrhoea and leucorrhoea. It is employed, also, in flabby, putrid, and offensive ulcers, in the carbunculus malignus, in chronic cutaneous affections, as tinea capitis, itch, (Deimann,) herpes, (Alibert,) cancrum oris, asthenic aphthae, &c. Lastly: ablution with a solution of chlorine, or of the chlorides, has been advised as a preventive of venereal infection. In can- cerous ulcers, it corrects the unpleasant odour, and excites a new action in the part; causing the secretion of a better pus: farther than this, we cannot expect much from it. Baths of chlorine are recommended by Wagner as an excellent means for preventing the plague. Schonlein advises that, in scarlatina, the whole surface of the body should be washed with a mixture of aqua chlorini and water, which he prefers to ablution with cold water. Finally;—the aqua chlorini is occasionally sprinkled in the sick chamber to purify the atmosphere during the prevalency of conta- gious or other diseases. MODE OF ADMINISTERING. As already remarked, whenever the aqua chlorini is prescribed, its facility of decomposition must be borne in mind. It is, for this reason, best to prescribe it with water only, or at most with the addition of simple syrup, for internal administration. For external use, water alone should be associated with it. As to the precise mode in which chlorine is affected by fatty substances, we have as yet no accurate knowledge; it may be calculated, however, that a part undergoes decomposition. Such combinations have, notwith- standing, been found very useful. The solution should never be prescribed in quantity larger than is necessary for twenty-four hours, as by frequently opening the vessel in which it is contained, decomposition readily ensues. The 136 NEW REMEDIES. vessel should be put into a dark place, and be surrounded by black paper. The average dose for an adult, in the twenty-four hours, may be fixed at an ounce, although much larger doses may be given with- out inconvenience. It is scarcely necessary to say that the precise dose must vary with the degree of concentration. Unguentum Oxygenatum ex tempore parandum. Ointment of Chlorine. &. Aquae chlorin. p. j. Adipis, p. viij. M. Used in the itch. Pharmacopoeia of Austria. Linimentum Aqua Chlorini. Liniment of Chlorine. &. Aquae chlorin. 3j. Olei olivar. ,gj. M. Externally in obstinate itch, tinea capitis, and herpes. Deimann. 3<. Cerae albae, ^ij. Leni calor. liquet", adde 01. amygdal. q. s. Ut fiat linimentum cui refrig. adde Aq. chlorin. giss. M. Used externally in cases of ulcers. Ltjdwig. Gargarisma Aqua Chlorini. Gargle of Chlorine. &. Pulv. tragac. gr. xij. Aquse, §iv. Aquae chlorin. Syrup, aa. ^ss. M. To be used as a gargle in ulceration and chronic inflammation of the mouth and fauces. Ratier.1 1 Formulaire pratique des h6pitaux civils de Paris, 3me edition. Paris, 1827. cinchonina. 137 CINCHONINA. Synonymes. Cinchonia, Cinchoninum, Cinchonin, Cinchonine. Although Duncan, of Edinburgh, Reuss, of Moscow, and Gomez,1 of Lisbon, had endeavoured to separate the active prin- ciple of the cinchonas, and had given the term cinchonine to a resinous extract obtained in their investigations ; the rnncur of discovering both cinchonine and quinine and of applying them to practical purposes belongs to the French chemists—Pelletier and Caventou.2 Cinchonine is commonly obtained from the gray or pale varieties of cinchona; the yellow furnishing the quinine, and thi red both cinchonine and quinine. It is an alkaloid strikingly analogous to the quinine in its chemical and medical relations, but is not as much used. method of preparing. Cinchonine is obtained by boiling the bark in alcohol, until it loses all its bitterness ; the alcoholic solution is then evaporated to dryness in a water bath ; the extract, thus obtained, is dissolved in boiling water, strongly acidulated with muriatic acid; an excess of calcined magnesia is added, which, after a few minutes' boiling, will fix all the red colouring matter, and render the liquid clear. When cold, the liquid is filtered, and the magnesian precipitate washed with cold water; it is then dried in a s\ove; and all the bitterness separated by repeated digestions in boiling alcohol; the alcoholic liquors are mixed, and the cinchonine crystallises as the fluid cools. The cinchonine, thus obtained, still contains a green fatty matter, which may be separated by solution in a very weak acid. If the acid be too strong, it will dissolve a part of the fatty matter, and the intended object will be thus defeated.3 Cinchonine may also be obtained by treating pulverised pale cinchona by weak sulphuric acid, precipitating the solution by means of lime in excess; collecting the precipitate on a filter, washing, and treating it, after drying, with boiling alcohol.4 1 Richter's Specielle Therapie, B. x. S. 325. Berlin, 1828, and Magen- die's Formulaire. 2 Annates de Chimie et de Physique, xv. 289 and 337. 3 Magendie, Formulaire, &c. 4 Pharmacopee Universelle, i. 414. Paris, 182S. 18 138 NEW REMEDIES. Cinchonine is white, translucent, crystallising in needles; re- quiring, for its solution, 700 parts of cold water, according to Magendie; according to others, 2500 parts of boiling water. On account of its very sparing solubility in water it has but a slightly bitter taste. In alcohol, it is readily soluble, and the solution is extremely bitter, as well as the salts formed by its union with acids, which resemble the salts of quinine. It does not dissolve readily in fixed or volatile oils, or in ether. At a certain tempera- ture, it volatilises; a great part, indeed, is destroyed by the opera- tion, yet a sensible portion escapes the decomposing power of the caloric. In medicine, pure cinchonine, as well as the sulphate and acetate, is prescribed. The sulphate is soluble in 54 parts of water, and in 6.5 parts of alcohol, (s. g. 0.815); it is not soluble in ether. It forms crystals and tastes bitter. The acetate, on the other hand, does not crystallise ; and is less soluble in water than the sulphate ; but an excess of acid facilitates the solution. EFFECTS ON THE ECONOMY. It is not necessary to say much on the application of cinchonine and its preparations to disease, as they have been almost wholly superseded by the quinine and its salts. It is a weaker article, and therefore requires to be given in larger doses; Magendie and Gittermann assert, that it has been found ineffective as a febrifuge. Bally,1 Chomel,2 Mariani,3 Wutzer,4 and others, however, have exhibited it successfully.5 Dufresne6 frequently prescribed it, and he assigns it this claim to preference, that it is almost tasteless, or at least that the bitter taste is but tardily developed; and that it needs not to be given in combination with acids, as the acid con- tained in the gastric secretions will render it soluble.7 He gave it in intermittents during the apyrexia in the quantity of from six to twenty grains, and he found it, moreover, of marked use in the ' Nouv. Biblioth. Medicale, ix. 189. 2 Nouv. Journ. de Medecine, Mars, 1821. 3 Osservaz. sulla Pratica del Solfato de Cinconina, &c. 4 Rust und Caspei's Krit. Repert. B. xxi. and Bulletin des Sciences Medic. Sept. 1827. 5 Art. Cinchonine, in Merat and De Lens, Diet, de Mat. Med. 6 Bibliotheque Universelle, Mai, 1831, p. 89. 7 See, also, Ganz, in Bulletino delle Scienze Mediche di Bologna, Agosto et Settembre, 1836, p. 121. CINCHONINA. 139 cases of gastralgia with formation of acid, which are so often met with in young females, and are not unfrequently associated with leucorrhoea, hypochondriasis, melancholy, &c. MODE OF ADMINISTERING. The following formulae have been recommended, but, as was before remarked, they are rarely used, the preparations of quinine being now almost universally prescribed. Syrupus Cinchonina. Syrup of Cinchonine. 3<. Sulphat. cinchonin. gr. xlviii. Syrup, simpl. fej. Used, in the same cases as the syrupus quininas, a tablespoon- ful for a dose. Magendie. Vinum Cinchonina* Wine of Cinchonine. B<. Sulphat. cinchonin. gr. xviij. Vini Maderens. Bsij. Magendie. Tinctura Cinchonina. 5<. Sulphat. cinchoninae, gr. ix. Alcohol (34° or s. g. .847.) gj. M. Magendie. Magendie recommends that this tincture should be used for preparing, extemporaneously, the wine of cinchonine, by adding two ounces of the tincture to a pint of Madeira wine. Boli Antifebriles} Febrifuge Boluses. &. Sulphat. cinchonin. gr. iij. Micae panis, Mellis, Glycyrrhiz. aa. q. s. ut fiat bolus. Dose,—one of these to be repeated every two hours. 1 Ricettario Clinico di Brera. Padov. 1825. Brera. 140 NEW REMEDIES. Mistura Cinchonina. Mixture of Cinchonine. 5». Sulphat. cinchonin. gr. vi ad xlviij. Potassae acetat. Sacchar. alb. aa. ^ss. Solve in Aqua? chamsem. §vj. Dose—A table-spoonful every two hours, in intermittents. Sundelin. CODEINA. Synonymes. Codeinum, Codeia, Codeine. German.—Kodein. Although opium had been repeatedly examined by the chemists, and certain of its active constituents separated from it, it was not until within the last few years, that the article, whose name is at the head of this paragraph, had been obtained from it. It was disco- vered by Robiquet in 1832,1 and as it has been exhibited as a thera- peutical agent, it requires notice. METHOD OF PREPARING. According to Winkler,2 this new alkaloid may be prepared in the following manner. The morphine is first thrown down from a solution of opium made in the cold by means of ammonia ; the meconic acid is precipitated by the muriate of lime; for the removal of the colouring matter, the fluid is then treated with the extract or subacetate of lead ; and the extract of lead, contained in the fluid poured off from the precipitates, is afterwards decomposed by sul- phuric acid; the fluid, separated from the sulphate of lead, is now treated with an excess of caustic alkali; the mixture is exposed to the air until the excess of free alkali has attracted carbonic acid from it; it is then agitated and digested with ether, and left to 1 Journal de Pharmacie, xix. 91 and 162. Paris, 1833. 2 Buckner's Report, xlv. p. 459, cited in Journal de Pharmacie, xxi. 251. Paris, 3835. codeina. 141 evaporate spontaneously, after which a yellowish, highly transpa- rent, but not crystalline compound remains, which forms with mu- riatic acid a crystalline salt, and resembles exactly the codeine of Robiquet. Merck1 procures the codeine in a very simple manner. He treats morphine precipitated by soda with cold alcohol; the spiri- tuous tincture is carefully saturated with sulphuric acid; the alcohol drawn off, and the residue treated with cold water as long as it is turbid ; it is then filtered, and the filtered liquid evaporated until it has the consistence of syrup: on cooling, ether is poured over it in a large flask; caustic alkali is added in excess, and the whole strongly agitated. The ethereal mixture is then so saturated that the codeine crystallises from it in a few hours. By evaporating the ether, and treating the residue with alcohol, the codeine is obtained by degrees wholly pure, and separated from an oily matter, which is a great obstacle to crystallisation. Codeine, according to Pelletier consists of 31 parts of carbon; 40 parts of hydrogen ; 5 parts of oxygen, and 2 of azote. It is an alkaloid, soluble in water, alcohol and ether; but not so in alkaline solutions. It unites readily with acids, and, with the muriatic acid especially, forms a salt, which crystallises with great facility. When the crystals of codeine are heated on a plate of platina, they burn with a flame without leaving any residue. Heated in a tube, they melt at about 150° centigrade; and, if allowed to cool immediately, they form a crystalline mass ; if, how- ever, the heat be continued, the oleaginous fluid rises along the sides of the tube, appearing to shun the heat; but it does not vola- tilise. When dissolved in water, codeine communicates to it deci- dedly alkaline properties. 1000 parts of water at 60° Fahrenheit, dissolve 12.6 parts of codeine ; the same quantity at 100°, 37 parts, and at 212°, 58.8 parts. If more codeine be added to boiling water than can be taken up, the surplus melts, and forms, like the meco- nine, an oleaginous layer on the bottom of the vessel. This aqueous solution, by careful refrigeration, affords a translucent and uncom- monly well defined metal. The tincture of galls forms a copious precipitate with a solution of codeine, in which respect, the latter differs essentially from morphine, as it does in many other of its properties. 1 Journal de Pharmacie, cited in Amer. Journal of Pharmacy, new series, i. 171. Philad. 1835. 142 NEW REMEDIES. EFFECTS ON THE ECONOMY. As morphine does not represent the whole of the activity of opium, Robiquet concluded, that other substances might concur thereto, and he conjectured that codeine might be one of those. Under this idea, Kunkel1 instituted experiments with it on rabbits and dogs, from which he obtained the following results. First. Codeine differs from morphine in this, that it does not, like the latter, paralyse the lower extremities. Secondly, Codeine appears to exert a powerfully excitant action. It occasions convul- sions of the limbs, and of the muscles of the neck, and when it pro- duces death, this seems to be owing to its action on the cerebellum and medulla oblongata; twice he noticed symptoms of backward progression under its use, and those parts after death were found turgid with blood. To judge from the condition of the heart and lungs it affects likewise the circulatory organs. It occasions in- flammation of the tissues, with which it comes into immediate con- tact. Its action is more energetic, when introduced into the cellular membrane, than into the stomach. It seems, also, to exhibit a special action on the urinary organs, for animals to which it is given never evacuate their bladder as long as they are under its influence. Thirdly. The action of codeine differs from that of the watery extract of opium, in not paralysing the hinder extremi- ties; but it approximates it in this, that it acts, as has been said, more powerfully when introduced into the cellular membrane than into the stomach, and accelerates the respiration and circulation. Kunkel, however, remarks upon the results of his experiments, that they demand repeated trials for confirmation, as he was only able to experiment with a very small quantity of the substance. Robiquet observes that Kunkel's experiments have led to the in- ference, that when codeine is combined with acids, it loses much of its efficacy—the very opposite, by the way, to the inferences of Magendie. Barbier2 has taken considerable pains to fix the value of codeine as a remedial agent. He prescribed it in the dose of one or two grains in a syrup, prepared with the aqueous solution of the alka- loid, of such strength, that a table-spoonful or half an ounce con- tained one grain of codeine. In his opinion, it exerts a peculiar agency on the nerves of the ganglionic system, whilst it appears to 1 Journal de Chimie Medicale, ix. 223. 2 Gazette Medicale, Mars 8: 1834. CODEINA. 143 possess but little influence on the hemispheres of the brain, and to make no impression upon the spinal marrow. In the epigastric region, he remarks, the agency of codeine is powerfully manifested; and here in the centre of the ganglionic system, its effects may be investigated, and their extent and magnitude appreciated. If a spoonful, or, at an interval of from one to two hours, two spoonfuls of the syrup of codeine be administered to one affected with the symptoms to be described immediately, we shall find, that it ex- hibits a considerable and remarkable effect upon the economy. If the person complains of pain in the epigastric region, beneath the lower extremity of the sternum, and stretching to the sides and back ; and if, with these symptoms, there is combined a feeling of heat, indescribable anxiety, marked debility, paleness, decided alteration of the features; a sense of painfnl traction sometimes on one side, at others in the other side of the epigastric region, with tendency to syncope, frequent sighing, despondency, and more or less sensibility to pressure in the epigastric region, ise, ii. 788. 3 Riecke, Die neuern Arzneimittel, S. 146. 4 Ueber den Cortex adstringens Brasiliensis. Koln, 1828. 20 154 NEW REMEDIES. face, and, after the outer bark has been separated, is somewhat smooth : on the inner side, it is of a brighter reddish brown, and, probably owing to the laceration of the woody splinters, somewhat fibrous. The younger bark is smooth in the fracture, and of a dull splendour." The older bark, which is thicker, is unequal, and may often be separated into fibrous layers, which are readily lacerable. AVhen chewed, it has a tolerably strong astringent, somewhat bitter and disagreeable taste, but it does not excite nausea, or leave any arriere-gout. It has scarcely any smell. In its chemical relations, it resembles the ratanhy.1 EFFECTS ON THE ECONOMY. Merrem, who made numerous experiments with this bark, affirms, that whilst it possesses the properties of astringents in general, and to a high degree, it is rather sedative than exciting, agrees with the digestive organs, and aids the peristaltic action. He employed it, first, with more or less success, in hemorrhage—in epistaxis, haemoptysis, and metrorrhagia; and Giinther2 found it very effica- cious in profuse menstruation arising from atony of the uterus. Secondly ; in mucous discharges, as leucorrhoea, blennorrhoea, &c. Thirdly; in inflammatory and exanthematous affections—as cy- nanche, urticaria, and in periodical erysipelas of the face. Fourthly; in nervous diseases, especially when combined with disturbance of the menstrual function, and leucorrhoea: and, fifthly; in weakness and catarrhs of the genital organs, bladder, and rectum. The In- dians consider, that the bark affects especially the generative appa- ratus, and, from the experiments of Merrem, it would seem, that its agency is more particularly exerted in cases of leucorrhoea ; and in many, after the cinchona had been administered without effect.3 MODE OF ADMINISTERING. Merrem prescribed it in various forms. He gave the powder in doses of from 9j to 3ss, three or four times a day, mixed with water. It appeared to him to act most beneficially in cases of mu- 1 See the analysis by Hofrath TrommsdorfT, in Brande's Archiv. B. xxxiii. S. 260; and Dierbach in Heidelberg. Annalen, B. x. H. 3. S. 357. Heidelb. 1834. 2 In Harless Rhein-Westphal. Jahrbuchern, B. viii. St. 1, S. 72; and Brande's Archiv. Band xi. S. 200. s Osann, in Encyc. Worterbuch der medicin. Wissensch. viii. 541. CORTEX ADSTRINGENS BR ASILIENSIS. 155 cous discharges unaccompanied by disorder of the digestive func- tions ; and he found that the powder was better borne by some than the decoction, which issomewhat singular, as the woody matter is more apt, in such cases, to disagree. He rarely gave it com- bined with aromatics, and never found the combination of use. To form the decoction, an ounce of the coarsely powdered bark was boiled with sixteen ounces of water, down to gviij; and to this an ounce of syrup was added. The dose was from one to two spoon- fuls every two hours. Merrem also prepared an extract, and a tincture, in the same manner as these preparations are made of the cinchona ; of the former he took from one to two drams, dis- solved it in six ounces of an aromatic water, and added gss of syrup. Of the mixture, a spoonful was given every hour. Externally, the decoction was injected three times a day in leucorrhoea, and in blennorrhoea; or, in the former disease, a sponge imbued with the decoction, was introduced, and kept there for some time. It has been applied, also, as an astringent to ulcers. Mistura Corticis Brasiliensis Adstringentis. Mixture of the Astringent Bark of Brazil. 3<. Decoct, cort. adstring. Brazil. ,5 vij. Copaib. cum vitelli ovi q. s. subact. Tinct. ferri pomati aa. 3;ij. Syrup, balsam. 3j. M. Dose.—A spoonful every two hours, in obstinate gonorrhoea and leucorrhoea. Merrem. 3*. Cort. adstring. Brasil. ^ss. Coque cum aquae fontan. q. s. Sub fin. coction. adde Herb, sabin. §ss. Colatura;, ^viij. adde Syrup, cort. aurant. ^j. Dose.—A spoonful every hour, in cancer of the uterus, and in the hemorrhage thence arising. Merrem. 156 NEW REMEDIES. CREOSOTON. Synonymes.—Creosotum, Kreosoton, Kreosotum, Creasoton, Creosote, Cre- asote, Kreosote, Kreasote. German.—Kreosot. This substance was first discovered, a few years ago, by Reichen- bach, of Blansko, and is extensively employed as a therapeutical agent. Its marked chemical properties suggested, that it might be possessed of a decided influence on the economy, and numerous experiments were immediately instituted to test the accuracy of the notion. These were of the most opposite character, and it is not surprising, as in every similar case, that there should have been great discrepancy in the results, and in the opinions deduced there- from. There can be no doubt, however, that the creosote forms a valuable addition to the list of our remedial agents. MODE OF PREPARING. The process given by Koene,1 is esteemed one of the best for preparing it on a large scale ;—almost the only way in which it is formed : we consequently meet with it only in commerce ;—being rarely made in the shops. Tar, derived from pit-coal, is distilled in a retort provided with a long tube, having a large mouth. Under this is placed a receiver. The oil, which comes over first, swims on water; and it is neces- sary to remove, from time to time, the products of the distillation, until an oil is obtained, which sinks in water. When this is the case, the product is collected. The heavy oil, obtained during the distillation, condenses not only in the receiver, but in the tube of the retort, where it unites with the naphthaline, forming a butyra- ceous substance. By applying a gentle heat, the mass will drop into the receiver. The product is now allowed to remain in a cool place for some hours, after which it is pressed. The expressed naphthaline still contains oil, which is separated by heating it with its own weight of acetic acid, until it melts. After allowing it to cool, the crystallised naphtha is pressed, and the acid adhering to the creosote is saturated with subcarbonate of potassa. The 1 Annales de Chimie et de Physique. Juillet, 1835. See Cormack on Creosote, p. 36. Lond. 1836; or the Amer. edit, in Dunglison's American Medical Library ; also, Turner's Chemistry, 5th edit. p. 872. CREOSOTON. 157 creosote is now to be shaken for a quarter of an hour with phos- phoric acid, the proportions being half an ounce of the acid to twenty ounces of the oil. The mixture ought then to be agitated with its bulk of water, and afterwards be distilled with a graduated heat, care being taken to separate the oil which floats on the sur- face. The rectified oil is now to be dissolved in its own volume of a hot solution of caustic potassa, s. g. 1.120. When it has been allowed to cool for half an hour, the supernatant oil is again re- moved, and the heavy oil again treated with caustic potassa, only a fourth part of the solution being, however, employed this time. On uniting the solutions of potassa, a slight excess of diluted phos- phoric acid is added, and the free creosote, which floats on the sur- face, is separated. It is again rectified ; and the first product— which is chiefly water—being rejected, the creosote comes over pure. M. Koene recommends the substance, thus prepared, to be preserved in bottles, covered with black paper. A protracted and complex process, like the above, necessarily makes the drug expensive, especially as the quantity obtained is but small. M. Koene procured by it ten drams from thirty-two ounces of tar. M. Lemere, one of the first Parisian pharmaciens who made pure creosote, obtained from eight hundred pounds of tar about six pounds of creosote. Reichenbach generally prepared it from the tar of the beech by six distillations; dissolving it afterwards in a solution of caustic potassa three times, setting it free successively by sulphuric acid.1 Giordano2 has recommended the following simplified mode for obtaining it. Distil wood tar from the willow, at an elevated tem- perature, from a tinned copper retort, until the residue has the con- sistence of a soft pitch. Re-distil the liquor passed over till its residue resembles the former. The liquor, neutralised by subcar- bonate of potassa, or lime-water, is re-distilled till all the oil of creo- sote has passed over. The oil is dissolved in caustic potassa, from 1 For an account of this and other products of the destructive distillation of vegetable matter, see Cormack, Op. cit. Reichenbach's observations and experiments are contained in a work entitled " Das Kreosot in chemischer, physischer und medicinischer Beziehung, von Dr. K. Reichenbach, u. s. w. Zweite mit Nachtragen und Zusatzen von Schweigger-Seidel verm. Aus- gabe. Leipz. 1835;" see, also, Annales de Chimie, liii. 325. Paris, 1833. 2 Annali di Medicina, Aprile, 1835, and Br. and For. Med. Rev. July, 1836, p. 283. For the process of Calderini, see Edinb. Med. and Surg. Journ. for Oct. 1834; and for that of M. Cozzi, see Journal de Chimie Me- dicale, and American Journal of Pharmacy, Jan. 1839, p. 339. 15S NEW REMEDIES. which, after simmering a little, in a porcelain vessel, and cooling, the eupione, which floats, is easily separated. The same opera- tion is repeated with the eupione, to remove all the oil that is united with it. The saponaceous liquor, treated with dilute sulphuric acid, is distilled into water, from which the creosote is separated, and the water saturated with creosote is kept for external use, or re-distilled for a concentrated acetic acid of a pungent and most agreeable odour. Creosote is a colourless, transparent fluid. Its refractive power is very great, and in angular glass vessels it is beautifully irides- cent. Its odour is penetrating-, and disagreeable, but not offensive: many compare it to that of castor. It adheres to every thing, and is somewhat permanent. Its taste is at first very burning and caustic to the tongue; but on admixture with the saliva, it becomes somewhat sweetish. It has an oleaginous feel, and is of about the consistence of oil of almonds. Its specific gravity, at 68° Fahr., is 1.037. It boils at 397°, and at—17° does not congeal. When placed on paper, it forms a greasy spot, which, however, dis- appears after a while, and can be removed by the application of a heated body, without any residue. It is a non-conductor of electri- city. With water at 68°, it unites in two different proportions;— one of the combinations consisting of 1| parts of creosote and 100 of water; the other of 10 parts of water and 100 parts of creosote. The taste of the first mixture—creosote water—is very burning at first, and afterwards sweetish, like that of pure creosote, but of course weaker. A drop of creosote in 10,000 parts of water pro- duces a marked impression on the tongue, and has a smoky smell. Litmus and turmeric paper are not in the least changed by it; so that it has neither an acid nor an alkaline reaction. At both poles of the galvanic battery, it furnishes numerous and striking combi- nations. It does not possess the property of the ordinary empy- reumatic oils, of becoming yellow and inspissated. It dissolves iodine, phosphorus, and sulphur. Acetic acid at 1.070, and alcohol, dissolve it in all proportions. Ether and petroleum likewise com- bine with it in all proportions. With potassa, it forms two or three combinations, one of which crystallises. Resins and resinous bodies either decompose creosote, or it decomposes them. With balsams, fixed and volatile oils, camphor, and the vegetable alkaloids it unites readily. It coagulates albumen, and its antiseptic property is most remarkable, whence its name, from xgea?, flesh, and oufy, I preserve:—amo%, " preserver." Fresh meat, placed in creosote water for half an hour or an hour, and then taken out and CREOSOTON. 159 dried, may be exposed to the heat of the sun without undergoing putrefaction. Nay, when flesh has begun to be putrid, the process ceases after it has been washed with creosote water, and if suffered to remain immersed in it for an hour, it does not subsequently pu- trefy. There can be but little doubt, consequently, that creosote is the main antiseptic and conservative principle of the pyroligneous acid, and of tar water. From the experiments made by Reichenbach to determine the exact components of the flesh on which the creo- sote acts, he arrived at the following results. It unites with the albumen and red particles of the blood in the flesh, which it coagu- lates, without acting on the fleshy fibre, which serves merely as the frame-work for the coagulated matters ; and it is well known that dried albumen does not putrefy, but becomes hard, brittle, and transparent. EFFECTS ON THE ECONOMY IN HEALTH. Reichenbach has properly remarked that the excessive burning pain in the tongue, which creosote causes, must have at once sug- gested it to be a poisonous substance. It was soon found that plants, sprinkled with creosote water, died; that fish placed in it were convulsed; and that small animals, as wasps and flies, died when touched with pure creosote. If a small quantity of it be spread upon the hand, and washed off a minute afterwards, the place is found to present a white appearance, but without pain or in- flammation. In the course of a few days, the place becomes dry, and the cuticle desquamates. When creosote is applied to a part where the epidermis is deficient, or to a wound, instantaneously an extremely violent burning pain is experienced, which continues for eight or ten minutes, but if the part be carefully washed, it gradu- ally ceases. The cause of this is conceived to be the property which creosote possesses of coiigulating albumen; and, where blood is flowing, of arresting it. If the rapid disturbance, which it excites, affects important organs, death results sooner or later according to their importance in the economy; relief, however, may be afforded by those substances that dissolve coagulated albu- men, as caustic alkalies, acetic acid, &c. It is probable, however, that the poisonous properties result from its acrid character. To appreciate the physiological effects of creosote, experiments have been undertaken by many individuals. Miguet gave a young dog, for eight days, an ounce a day of distilled water containing four drops of creosote, without any effect. When, however, he % 160 NEW REMEDIES. doubled the dose, nausea, languor, subsultus tendinum and tremors occurred, followed in the course of a few days, by marked emacia- tion. On discontinuing the creosote, the functions gradually re- sumed their pristine condition, and the animal recovered its flesh. To another dog, he gave at once two drams in half an ounce of water, and immediately thereafter great prostration of the muscular system ensued—vertigo, fixed eyes, stupor, dyspnoea, accumulation of mucus in the air passages, spasmodic cough, discharge of large quantities of foamy saliva, with vomiting of a milky matter, al- though the animal had taken nothing of the kind. After two hours of suffering, the animal died of convulsions. The body was im- mediately opened ; all the tissues, except the liver, exhaled a strong smell of creosote ; the whole of the mucous membrane of the intes- tinal canal was inflamed. The matters contained in the stomach coagulated when placed in contact with albumen. When heated, they yielded a thick smoke, and a marked smell of creosote. In the heart and large vessels the blood was more firmly coagulated than usual: the lungs were gorged with blood ; in the brain there was no evidence either of congestion or hemorrhage. In another dog, into whose carotid equal portions of water and creosote were injected, death resulted" with similar phenomena, but more rapidly. The precise quantity of creosote used in this ex- periment is not stated. Simon, in his experiments, found that when ten drops of creosote, diluted, were injected into a vein, scarcely any effect resulted. Reiter and Muller, who likewise made experiments on animals, agree with Simon as to the result of injections of creosote into the veins ; no special symptoms were induced by it, but this appeared to be owing to the blood being instantaneously coagulated by it, which not only prevented the farther progress of the creosote, but also of the blood, hence no evil consequences resulted; and it is probable, as Riecke has suggested,1 that the weaker the solution of creosote, within certain limits, the greater may be its effect on the mass of blood. Corneliani,2 an Italian physician, has also instituted a series of experiments with creosote on lambs, rabbits, &c. All these animals bore small doses of creosote—however unwillingly it might be 1 Die neuern Arzneimittel, u. s. w. S. 153. 2 Giornale delle Scienze Medico-Chirurgiche, No. 8. Febrajo, 1835; Brit. and Foreign Med. Review, p. 265, Jan. 1836, and Journ. de Chimie Medi- cale, Fev. 1836. CRE0S0T0N. 161 taken—without any remarkable results, and without loss of appe- tite. Large doses, however, immediately occasioned general torpor, sudden inclination to pass the urine, paralysis—especially of the lower extremities—with or without convulsions, and frequently the ejection of a bloody foam. When the doses were large, and it was but little diluted, death took place in a few minutes, and on exami- nation, the inner lining of the stomach was generally found cor- roded, yet not so constantly as to allow of death being ascribed to that circumstance. It followed, farther, from his experiments, that pure creosote ap- plied to a denuded nerve, or injected only in small quantities into a vein, may occasion death suddenly, and that the application of the creosote to extensive wounded surfaces in the same animals may be ultimately followed by fatal consequences. Where a very large dose of creosote was administered, immediate death was produced without organic lesion. In the trials made with it by Dr. EUiotson,1 he found no action produced upon the bowels; but it sometimes augmented the quan- tity of urine. He once saw it, in doses of a minim three times a day, cause micturition nine times in an hour. In another case, in doses of three minims, it produced severe strangury. According to Simon, when applied to the muscles, it destroys the surface like a caustic. Muller and Reiter, in their experiments, found that it speedily rendered the muscular fibres of a dirty whitish ap- pearance, and readily lacerable. When applied to the fresh blood of the hog, it converted the colour in an instant to an ashy gray ; after which it became black and quickly coagulated. Mixed, either pure or diluted, with blood, it thickens it, the mixture assumes a brown red colour, and it is found studded with small white points, which are nothing more than coagulated albumen. On exposing the coagulum to the air, it assumes a yellowish red colour. Reich, on the other hand, who appears to have made many experiments with creosote, both in internal and external dis- eases, affirms, that he has never observed any caustic effect from it ■ from which assertion, as Riecke has remarked,2 the only inference to be deduced is, that he must always have applied it largely diluted. Fremanger likewise asserts, that when pure creosote is applied to the epidermis, it does not destroy it; but merely occa- sions more or less redness of the skin. When applied to a suppu- 1 Medico-Chirurg. Transact, vol. xix. Lond. 1835. 1 Op. cit. S. 154. 21 162 NEW REMEDIES. rating surface, it caused, instantaneously, the formation of a white pellicle, owing to its coagulating the albumen contained in the secretion from the wound. Adventitious tissues, with which it is brought in contact, are destroyed by it. When placed between the lips of a wound it prevents healing by the first intention, by coagu- lating the albumen, and, consequently, it may be employed in all cases where it is desirable to prevent the growing together of parts. Fremanger is, indeed, disposed to refer all its efficacy to the action, which it exerts on albumen. Its long continued use often occasions an inflammatory condition which, as Dr. J. L. Da Luz1 observes, has nothing in common with the disease, for the cure of which it may have been prescribed. In a case of porrigo favosa treated by it recently by the author, febrile irritation supervened, and the head was covered by an arti- ficial eruption, which induced, however, a new action in the inter- mediate system of the scalp, and after its subsidence, the porrigo was cured. Dr. Cormack, of Edinburgh, has likewise instituted various ex- periments on the lower animals to test the physiological effects of creosote.2 In three experiments, about twenty-five drops of pure creosote were injected into the venous system of dogs. All the animals died. In every case of poisoning by it, which he has ob- served, Dr. Cormack found the following to be the symptoms:—Its first deleterious action was a powerful one of sedation on the heart; the vital energies of that organ seeming to be instantaneously para- lysed. In some instances, hurried and sonorous respiration went on for more than a minute after the heart had ceased to beat. In general, one or two convulsions, resembling the tetanic, preceded death ; and, almost invariably before expiring, the animal uttered one or more shrill cries. In every instance, the atony of the heart immediately after death was very striking. From other experiments it appears, that when creosote is injected into the arteries the deleterious effects are of a much milder cha- racter, and if the dose is not large, the animal may experience but little inconvenience ; a circumstance, which proves the importance of a thorough admixture with the blood before the poisonous article reaches the heart ; such admixture not taking place, to the neces- sary extent, when the poison is injected, into the veins, but being 1 Jornal da Sociedade das Sciencas Medicas de Lisboa, torn. v. Lisboa, 1S37 ; reviewed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. 2 Op. cit. p. 66. CREOSOTON. 163 readily effected when injected into the arteries, and consequently distributed through the capillary or intermediate system. When taken for any length of time, the urine acquires a blackish hue, and in some cases it can be recognised in the urine.1 EFFECTS ON THE ECONOMY IN DISEASE. Creosote has been administered in various diseases, and the fol- lowing may be esteemed a summary of the therapeutical experi- ments made with it. 1. Hemorrhage. The discovery of creosote happened at a time, when the Aqua binelli enjoyed more confidence as a styptic than it does now ; and the fancied probability, that the nostrum was in- debted to the creosote for its properties, gave rise to many experi- ments with the latter in cases of hemorrhage. One of the first, who instituted experiments with it on rabbits, was G. Simon. Not being able to obtain any striking results from the aqua binelli, he tried the creosote, pure, as well as in the form of creosote water, and of an emulsion prepared with gum arabic ; and from the results of these he was led to affirm, that although creosote occasioned the coagulation of the albumen of the blood, it acted no better as a styptic than cold water. With the aqua binelli he was not able to coagulate albumen. The rapid separation of the albumen in the form of a reddish gray coagulum under the influence of the creo- sote, he found to be of no advantage, as the mass remained soft and pulpy; and the wound in the vessel could not close, but was im- mediately opened by the stream of blood. Neither did he esteem it adapted for arresting trifling hemorrhages; for, when very much diluted, it is still too exciting to the injured parts, and markedly delays their union. This, indeed, might, he thinks, be expected from the fact, that pure creosote, when placed on the skin for ten or twenty minutes, induces superficial inflammation. The experiments of other physicians have been decidedly more favourable. Muller and Reiter,2 for example, in theirs, found that creosote was far more efficacious than the aqua binelli, for, when the latter was prescribed, it was always necessary to have recourse to other agents, before the hemorrhage was arrested. In their ex- periments on dogs, they found the hemorrhage from a divided 1 Dr. Macleod, in Medical Gazette, xvi. 599, and xvii. 653. 1 Schmidt's Jahrbuch, cited in Encyclographie des Sciences Medicales Mars, 1837. 164 NEW REMEDIES. crural vein quickly cease, when a compress of cotton, wetted with creosote, was placed on the vessel, with a moderate degree of pres- sure. Three days afterwards, the crural artery was exposed on the same dog, and divided; but it was afterwards necessary to tie it, as the creosote, in consequence of the excessive hemorrhage, could not be brought into immediate contact with the vessel, but merely acted on the superficial layer of blood, and therefore did not arrest the hemorrhage. The crural artery of a young and tolerably strong dog was cut a short distance above its division, compression being at the same time exerted upon the trunk. The artery did not bleed. Nine minutes afterwards, a compress of cotton soaked in creosote was applied immediately to the divided extremity of the artery, with some degree of pressure. When the compress was removed, the bleeding was entirely arrested, and the wounded surface was dry, and had an ashy gray hue. In an old dog, hemorrhage from a divided crural artery was arrested by the same means, but not so speedily. When the artery was examined, it was found to be wholly closed, having a navel-like depression at the extremity, which disappeared when the vessel was pressed upon, and ultimately became conical. Within the vessel was a conical coagulum, which could be readily detached ; and for the space of a line, the artery appeared inflamed through its coats. In arteries that had been divided for a longer time, the union was likewise complete; but there was this difference, that the in- flammation at the end of the vessel had disappeared, and a pointed fibrous caruncle was observed in the vessel, which was doubtless the fibrinous portion of the previous coagulum. From their experiments, Muller and Reiter were led to confirm the haemostatic properties of creosote, both when the hemorrhage occurs from veins and from arteries. The arteries divided were of considerable size, larger than the radial artery of an adult male. They consider pressure indispensable to occasion the creosote to act immediately on the artery; and the arrest of the hemorrhage, they ascribe,—not alone to the coagulation of the blood, but to the con- traction of the arteries. In parenchymatous hemorrhage, the aqua creosoti was generally sufficient; as well as in tolerably extensive wounds of the surface. Horing, also, obtained satisfactory results from his experiments on animals. He exposed, on an old cat, the crural artery and vein of the right side; made a small incision into the latter, and pressed upon it to stop the copious flow which ensued: he then applied CREOSOTON. 165 over the wound, for two minutes, a small compress of lint, wetted with a solution of creosote—two drops to one hundred of water—and the bleeding ceased. The artery was now opened, and a similar compress placed upon it with the same result. Two days after- wards, a second experiment was made of the same kind, except that, owing to the struggles of the animal, a larger opening was made into the crural artery. In this case, it was necessary to apply the compress for four minutes before the hemorrhage ceased. In another cat, a large transverse incision was made on the inner sur- face of the right thigh, above the middle, by which muscles, arte- ries, veins, and nerves were divided. Two large compresses of lint, wetted with a solution of creosote, were then pressed on the parts for five minutes, and the bleeding entirely ceased. The like result was obtained in the case of an old horse, whose jugular vein was opened. But the creosote solution did not succeed in wholly arresting the hemorrhage in the same horse, when an opening was made into the crural vein and artery. To these experiments on animals may be added some that were instituted on the human subject, and which testify, more or less, to the efficacy of creosote as a haemostatic. Hahn applied it in some insignificant cases, but saw no better effect from it than from cold water. Most found it speedily arrest slight hemorrhages from small vessels. Horing applied it successfully in a case df epistaxis, which had obstinately resisted other agents,—two plugs of lint, dipped in a solution of creosote being inserted in the nostrils, after which the hemorrhage soon ceased. Fichtdauer employed it with equally advantageous results in violent bleeding from leech bites, after several haemostatics had been used in vain ; and Heyfelder extols it for arresting hemorrhage from large wounded surfaces. Berthelot differs with Fremanger and Simon, who affirm that union by the first intention is prevented by it. The results of his obser- vation were entirely opposite. Miguet applied it successfully as a haemostatic in fresh wounds on man and animals. Both pure creo- sote and a solution of it were, however, unsuccessfully used by Bardili in hemorrhage from the arteria tibialis postica, which he ascribed to the blood having lost its albumen, owing to the exces- sive discharge. Reich and Hauff found injections with creosote water very useful in haemorrhagia uteri. Schneider had a case of hemorrhage that had continued for seven hours in a man eighty years old, and which proceeded from the gums of the upper jaw • the blood oozing as from the pores of a sponge. He directed the man to take as much aqua creosoti into his mouth as he was able; 166 NEW REMEDIES. and after three repetitions the hemorrhage ceased, and did not recur. Kohler1 endeavoured to test the haemostatic operation upon him- self. He made an incision in his forearm an inch long, and three or four lines deep, to which he applied creosote water. A lanci- nating pain was felt in the wound, but no other sensible effect. A drop of pure creosote was now let fall between the lips of the wound : this was followed by a sensation of burning and drawing; for a moment, coagulated flakes of a whitish gray colour covered the wound, and there was a temporary cessation to the flow: it soon, however, recurred. After a time the hemorrhage ceased ; but not sooner—Kohler thinks—than if cold water had been applied. The feeling of burning and drawing continued, however, for some time; the edges of the wound were somewhat swollen, and oede- matous, and, in about four hours, were covered with a yellowish brown lymph; but there seemed to be no delay in the cicatrisation. J. L. da Luz2 found it an excellent styptic in capillary hemor- rhage ; but in hemorrhage from great vessels it does not prevent a recurrence of the bleeding. In haemoptysis, too, the internal use of creosote has been found beneficial. Santini3 prescribed it in a desperate case with complete success, and with Schmalz it was equally effective; on the other hand, it was of little avail in Guitti's hands. 2. Burns.—Most used creosote with decided relief in burns of the second and third degree, applied by means of rags wetted with creosote water. Berthelot also cured two cases quickly with it; the slightly burnt places becoming desiccated ; the more severe healing by the formation of a crust. Guitti applied both creosote water and creosote ointment with advantage in burns which had proceeded to profuse suppuration ; hence, it has been advised,— 3. In profuse suppuration, on the authority of Levrat and Ber- thelot, but according to J. L. da Luz,4 it has no marked influence on the secretion of pus, and is therefore useless in suppurating ab- scesses. In otorrhoea it. has been especially beneficial. 4. Lesions of the integuments.—According to Reichenbach, creosote is of essential service in the intertrigo of children, as well as in the excoriation induced by lying. In the latter case, Guitti 1 Neue wissenschaftlich. Annalen, u. s. w. B. i. H. 3. S. 285. Berlin, 1835. 2 Op. cit. s Gazetta Therapeutica di Verona, Mars, 1834; and Amer. Journal of the Med. Sciences, Feb. 1836, p. 502. * Op. cit. CREOSOTON. 167 used it with success. Hahn also frequently employed it. In cases where ulceration had not taken place, he washed the parts several times a day with creosote water, and was of opinion that he had prevented, in some cases, the occurrence of ulceration. Where ulceration had already taken place, he covered the parts with linen rags folded two or three times, which he soaked in creosote water, and fixed them on by means of adhesive straps. The superficial ulcers soon healed; and the deeper were transformed into hollow surfaces, secreting a homogeneous serous fluid, but no pus. Horing employed creosote water with advantage in sore nipples; and in sprains and contusions, the creosote ointment has been re- commended by Dr. Fife.1 5. In chilblains, whether ulcerated or not, Hahn2 used creosote washes successfully;—the affection yielding in a few days: and Dr. Herndon3 regards the creosote ointment as the best remedy in that affection with which he is acquainted. 6. Ulcers.—Fissures of the skin and superficial ulcers, according to Hahn, were changed, under the application of the creosote, water, into a blackish brown scab, which adhered for a long time, and when it fell off, left the parts healed; or by occasioning too much shrinking of the parts, gave rise to fresh inflammation and suppu- ration. Deeper ulcers were affected in the same manner as those caused by long lying. The efficacy of this agent in atonic and varicose ulcers, espe- cially of the leg, has been attested by Levrat, Berthelot, Rossi, Hechenberger, and others; but Guitti, Heyfelder, and Schmalz were less satisfied with it. Very recently, a case of indolent ulcer, between the knee and ankle, accompanied with a good deal of in- flammation, was cured, by Dr. Crary, in five weeks, by the appli- cation of a solution of creosote (ten drops to the ounce of water), with methodical compression to the limb, by means of a bandage.4 Meister found the application of creosote water, in cases of carious, scrofulous, syphilitic, fistulous, and sanious ulcers, to be strikingly, and almost uniformly useful. Heyfelder, likewise, found it extra- ordinarily useful in scrofulous ulcers, and Dr. Cormack5 states, that he had recently an opportunity of seeing a ca^e of this kind treated by Dr. Shortt, in the Royal Infirmary of Edinburgh, 1 Lond. Med. Gazette, April 7, 1838, p. 66. a Gazette Medicale de Paris, Dec. 1834. 3 American Med. Intelligencer, for March 15, 1838, p. 425. 4 Boston Medical and Surgical Journal, July 3, 1839, p. 332. 8 Op. cit. p. 106. 168 NEW REMEDIES. where an extensive scrofulous ulcer of the hip, after resisting a variety of treatment, at last yielded to creosote, and was ulti- mately completely cicatrised. On the other hand, Otto tried both the pure creosote and the watery solution in ulcers of various kinds, especially the scrofulous ; the ulcers very generally put on, in the course of twenty-four hours, a cleaner appearance; still they did not cicatrise, on which account Otto prefers, in old ulcera- tions at least, the use of a solution of chloride of lime; for notwith- standing creosote diminished and improved the character of the suppuration from scrofulous ulcers, and rendered them cleaner, it did not ameliorate the general condition ; after the diminution of the suppuration, local pains, loss of sleep, and slight febrile move- ments generally supervening. On these accounts, Otto does not think creosote applicable to scrofulous ulcers in general. In scrofulous caries, many observers depose to the good effects of creosote. Among these may be mentioned Hahn, Coster, Ritgen, Fremanger, and Hauff. In fistulous ulcers—also of syphilitic origin—several physicians have employed it beneficially. Dr. Fife,1 of Newcastle-upon-Tyne, found it useful not merely in obstinate but in malignant ulcers. In no case of ulceration, he affirms, in which he tried it, did it disappoint his expectations. In a sloughing carbuncle, the alcoholic solution, (thirty drops to the ounce,) mixed with carrot poultices, was applied with advantage by Dr. Herndon,2 of Culpeper C. H., Virginia. In scurvy and in scorbutic ulcers, M. Coen3 found its use followed by excellent results, and he refers to cases in which it has been ad- ministered internally with very great advantage. J. L. da Luz4 considers it an excellent cleansing remedy in atonic ulcers, but its prolonged use, he thinks, retards cicatrisation. In hospital gangrene, he esteems it the best antiseptic, and the most powerful means for checking its terrific progress. In gangrenous or sloughing ulcers, Hahn used it. Several times a day he penciled the slough with pure creosote, and, in the inter- vals, fomented it with creosote water. According to Reichenbach, two offensive affections of the labia pudendi—the consequences of infiltration of blood—were cured by it; and Reich and Sir Francis 1 London Medical Gazette, April 7, 1838, p. 65. 1 Amer. Med. Intelligencer, March 15, 1838, p. 425. 8 Giornale per servire &c. di Venezia, 1836. 4 Jornal da Sociedade das Sciencas Medicas de Lisboa, T. v. Lisboa, 1837; noticed in Zeitschrift fur die gesammte Medicin. Oct. 1838, S. 224. CRE0S0T0N. 169 Smith1 treated with success cases of cancrum oris, and the former, one of scorbutic ulceration of the gums. In herpetic ulcers, Hbring and Berthelot observed favourable effects from the creosote water; and it has been found especially useful in carcinomatous and syphilitic ulcers, in which it has been often employed. In cancer of the uterus, Wolff injected creosote water, in two cases, into the vagina. In one, the pain was so great, that, on the ninth day, after six pints of creosote water had been used, it was obliged to be discontinued. In the other case, the treatment was continued twenty-six days, and sixteen pints were used : in it, also, the pain was sensibly aggravated. The secretion was not improved in either case; nor was metrorrhagia prevented by it; for one of the patients died immediately after an attack of this kind : the other lingered a long time. Heyfelder found injections of creosote water, in conjunction with the extractum calendulse, of no use in cancer uteri. On the other hand, in a case of superficial ulceration of the os uteri with copious discharge of a puriform mucus, which had been treated unsuccessfully by other agents, for several months, Hahn found an injection of creosote water effectual in fourteen days. Tealier2 has likewise given a case of superficial ulcerations around the os uteri, to which nitrate of silver had been applied at least twenty times without inducing a cure. By touching the ulcers with lint fixed upon the end of a probe, and dipped in a mixture of one part of creosote and three parts of water, excessive pain was induced, but this gradually passed away, and in six days the signs of ulceration had disappeared. It is more than doubtful, however, whether either of the two last cases was carcinomatous. In a case of cancer of the breast, a solution of creosote was ap- plied by the same gentleman. This excited, instantaneously, vio- lent pain, but after a time the pain ceased, and relief was obtained. Rossi saw a cancerous ulcer of the face healed by creosote oint- ment, but it soon broke out again. The same gentleman cured a fungous tumor on the alveolar margin of the right os maxillare— which had occasioned the loss of all the teeth of that side except one, and which even the actual cautery had not prevented from 1 Dublin Journal of Med. Science, for May, 1837. 3 Revue Medicale, Fevrier, 1834. For similar cases, see Dr. Friese, in Berlin, medicin. Zeitung, Nro. 13, 1837. 22 170 NEW REMEDIES. returning—by a collutory of six drops of creosote in six ounces of water. Heyfelder saw creosote used without effect in a case of cancer of the skin, and Cormack1 in a case of lupus of the nose. On the other hand, Guitti cured an ulcer, in appearance cancerous, by the application of pure creosote, for which, at a later period, the solu- tion was substituted, and Marchal has published a case of cancer of the lip in which he believes he accomplished a cure by means of creosote.2 Garbiglietti cured a fungous ulcer with caries of the fibula by creosote, but it is questionable whether the ulcer was carcinoma- tous ; and Meisinger saw a cancer of the face improved by the use of creosote ointment. It has been before remarked, that Meisinger used creosote with advantage in syphilitic ulcers. Hahn also applied creosote water in primary syphilitic sores ; the small, superficial ulcers healed soon, the larger and deeper remained stationary. In a phagedenic ulce- rated bubo, the spreading was arrested, but this was all. According to Heyfelder, creosote—probably the pure—excited, in a case of primary syphilitic ulcer, in a plethoric individual, violent inflam- mation, and so much sensibility, that it was obliged to be discon- tinued. Berthelot cured a chancre, which had resisted caustics and other cicatrising agencies, in a few days, by creosote water. Rehfeld, also, treated secondary syphilitic ulcers successfully with it, giving, however, at the same time, the corrosive sublimate, in- wardly. Chronic venereal ulcers have in some cases yielded to it, after they had resisted every other kind of treatment.3 Dr. Burkner, of Breslau,4 reports a case, which, after having proved rebellious to every kind of general and local management that could be devised, at length yielded to the application of pure creosote, by means of a camel's hair brush. The character of the secreted pus immediately improved ; the wound began to heal by granulations from the base, and, at the end of four weeks, Dr. Burkner found his patient quite well. In condylomata it has been equally successful. By the appli- cation of creosote water, Hahn found them contract and disappear; but the more obstinate required to be penciled with pure creosote. 1 Op. cit. p. 115. 2 Gazette Medicale de Paris, Fev. 1835. 3 Cormack, Op. citat. p. 107. See, also, Kunchel, in Bulletin Gener. de Therapeutique, p. 313. Paris, 1833. 4 Casper's Wochenschrift, Sepr. 9, 1837, S. 583. CRE0S0T0N. 171 Heyfelder, Reich,1 Fricke, and Coen,2 also found the creosote effica- cacious in these cases. The last gentleman but one had the most fre- quent opportunities for observation : by him the creosote, in a dilute state, was applied to the top of the condyloma by means of a pencil. In cases of small condylomata, touching them once or twice was sufficient for their removal; of larger, it had to be more frequently repeated. In some obstinate cases, it required two or three weeks before the condylomata disappeared; but when once they fell off, they did not return. 7. Gonorrhaa and Fluor albus.—Most extols creosote water as a remedy in gleet. He applies it either in the way of injection or by small tents wetted with it and introduced into the urethra. In fluor albus, he strongly recommends both the internal and external use of it. Reich injected creosote water in a case of gonorrhoea, and in one of malignant fluor albus; yet its agency in these cases was doubtful as copaiba was given at the same time. Hahn3 also used injections of creosote water in the second stage of gonorrhoea, and in gleet; but he did not think that the discharge ceased sooner under its agency than under the ordinary means ; whilst in some cases, the inflammation was even augmented. In two cases of benign fluor albus, after many other remedies had been employed in vain, Schmalz saw good effects from the use of a solution of creosote; but in a third case it afforded no relief. Dr. EUiotson4 gave it internally to a female labouring under gonorrhoea, at first, in the dose of two minims to an ounce of water, and afterwards in the dose of four, six, and even eight minims, but no good resulted from its use. We have administered it not unfrequently in leucorrhoea and other mucous discharges, and when persevered in, it has_at times appeared to be of decided service.5 Recently Dr. Robert Dick,6 of Glasgow, has called the attention of the profession to its use in the chronic stage of gonorrhoea, and in gleet. He thinks its beneficial effects are more obvious than those of copaiba. He administered it in doses of two drops with loaf sugar beaten in a syrup with water. 8. Chronic cutaneous affections.—Reich treated a case of crusta 1 Hufeland's Journal, Jan. 1834, and Revue Medicale, Mai, 1834. 2 Giornale per servire a progressi della patologia, &c. di Venezia, An. 1836. 3 Gazette Medicale de Paris, Dec. 1834. 4 Lancet, for Dec. 1835, p. 435. 5 See, also, Coen, in Giornale per servire, &c. di Venezia, 1836. 6 Edinb. Med. and Surg. Journ. Apl. 1838, p. 602. 172 NEW REMEDIES. lactea externally by creosote, and internally by calomel and the black sulphuret of mercury. The result was favourable. In the itch, it was recommended by its discoverer. Wolff, too, saw three cases of not very recent itch, cured in eight days by lotions of creo- sote water. Reich and Coen1 likewise extol the water and the ointment iu inveterate itch. J. L. Da Luz2 also considers it as valuable as sulphur, but Otto did not find the water particularly efficacious. He gives strong testimony, however, in its favour, in herpetic eruptions; in a very short time, it induced evident im- provement, and often removed the affection in from eight to four- teen days. When the cases were more chronic, a longer time was of course required for the cure. He never administered it, however, without attaining his object. His rule was, to bathe the affected parts twice a day with creosote water, and in particular cases he directed, in addition, general baths of warm water. The eruption generally disappeared very rapidly under this management, but it speedily recurred unless general bathing was used at the same time. It again yielded, however, very readily to creosote water. Grand- jean, Reich, and Koehler, also employed the water successfully in herpes ; and Guitti found both the water and the ointment most serviceable in herpetic affections when combined with appropriate internal treatment. Heyfelder recommends that alterative drinks, as the decoctum sarsaparillae, should be combined with them. Even in herpes exedens, the external application of creosote was found effectual by Ritgen, Grandjean, and Rossi. Wolff3 cured a case of ancient impetigo in about eight weeks, by a solution of creosote (3ss to §v of distilled water.) At first, the application caused so much heat and inflammation, that in eight days it was obliged to be discontinued, and afterwards it was alternated with fomentations of warm water from day to day until the cure was completed. Dr. Herndon of Culpeper C. H., Va., derived much benefit from the ointment in psoriasis. In a case of acne rosacea of seven years' standing, accompanied with headach, nervousness, thirst in the morning and acid eruc- tations, for which the patient was put under treatment for a month without success, Dr. EUiotson4 determined on trying creosote. 1 Op. cit. 2 Jornal da Sociedade das Sciencas Medicas de Lisboa, torn. v. Lisboa, 1837, noticed in Zeitschrift fur die gesammte Medicin. Oct. 1838. S. 224. a Medicin. Zeitung, u. s. w. No. 30. 1834. 4 Lancet, July 4, 1834, p. 459. CREOSOTON. 173 The advantage was soon manifest, as in three days the eruption was evidently diminished. At first, she took two minims three times a day ; this was gradually augmented to twenty minims ; the farther increase of the dose being prevented by the supervention of giddiness and tremors. At the end of seven months, she was dis- charged ; the eruption being scarcely perceptible, and the dyspeptic symptoms entirely removed. In a chronic pustular disease, not curable by antiphlogistics, the same gentleman observed better effects than from any previous remedy.1 Dr. Copland, it is affirmed, found a saturated solution in water answer well as a lotion in porrigo favosa.2 We have often used in porrigo, both creosote water and creosote ointment (see the formulae at the end of the article); they have always appeared to us sufficiently strong, and when the quantity of creosote was increased, so much inflammatory irritation was induced that they had to be discontinued for a time. 9. In a case of chronic inflammation of the free edge of the eye- lids, with several ulcerated spots, a cure was effected by Coster, by the use, twice a day, of a dilute solution of creosote, (gtt. xij ad aquae destillat. gij) applied by means of a camel's hair pencil. The cure was effected in ten days. In different kinds of ophthalmia, M. Sanson used the creosote, but never observed the disease to be modified by the treatment.3 10. In a case of prolapsus vagina, Schlesier tried the external use of a solution of creosote. After astringent injections, and the application of the decoctum ratanhiae by means of a sponge, had been used in vain, he injected diluted creosote for seven weeks, omitting it only at the time of menstruation. It excited a burning sensation of a few minutes' duration. At the expiration of the time mentioned, the prolapsus had strikingly diminished, and the great sensibility of the prolapsed parts had disappeared. Owing, however, to the supervention of irritation in the urinary bladder, it had to be discontinued when there was every prospect of ultimate success. 11. Dr. Buttmann,4ofVietz, circle of Landsberg, has given the case of an old lady, upwards of seventy years of age, who had laboured 1 Medico-Chirurg. Transact, xix. 237. Lond. 1835. 2 Gully's Edition of Magendie's Formulary, p. 204. Lond. 1835. See, also, Sir F. Smith, in Dublin Med. Journ. for May, 1837, and J. L. Da Luz, Op. cit. 8 Compt rendu des Seances de la Societe de Medecine, Seance du 7 Mars, 1834. 4 Beitragen zum Sanitats-Berichte des Frankfurter Regierungs-Bezirks: and Medicinische Zeitung, Dec. 7, 1836, S. 252. 174 NEW REMEDIES. for several years under oedema of both legs to such an extent as to interfere materially with progression. She experienced lancinating pains in both feet, and irregular paroxysms of fever. Many external and internal remedies had been used in vain, when Dr. Buttmann, by way of experiment, applied cataplasms of creosote, soon after which the swelling, very much to his astonishment, gradually dis- appeared, and with it the febrile attacks. 12. In toothach from carious teeth, creosote has often been used, being applied to the hollow of the tooth by means of a pencil, or of cotton imbued with it. The testimony in its fa- vour has been very great,—Coster, Reich, Hahn, Kneisel, Hey- felder, Fichtbauer, Hauff, Otto, Guitti, Kohler, Meisinger,1 and numerous others. Some have advised a collutory of creosote, but this is more disagreeable, whilst it is less efficacious than creosote applied immediately to the carious tooth. It excites instantaneously acute pain and a considerable secretion of saliva. The pain is often relieved by it, but it generally recurs; and perhaps the ad- vantage derived from this agent is not greater than from the stronger essential oils. As a palliative it is very useful. In rheu- matic toothach, the insertion of a little cotton, imbued with creo- sote, in the ear of the same side, has been found serviceable.2 13. In deafness, apparently owing to a deficient secretion from the meibomian follicles, advantage has been found from the use of the creosote, after the ear had been syringed. Perhaps as good a form as any is that recommended by Mr. Curtis,3 which consists of one dram of creosote to four drams of lard. A little of this oil is inserted into the meatus night and morning, with a camel's hair pencil. He considers the preparation contra-indicated in cases of otorrhoea, where there is any pain or inflammation. So far we have spoken mainly of the external use of creosote. Reference has been made to its internal administration in cases of haemoptysis and fluor albus only. In the following diseases, it has been chiefly given internally:— 14. Phthisis.—Reichenbach excited considerable expectations from the use of creosote in phthisis,—pulmonary, laryngeal, and bronchial; and as in so intractable a disease every suggestion is 1 Medicin. Jahrbuch. des k. k. osterreich. Staates, B. xv. S. 553. Wien, 1834. 2 Riecke, Op. cit. S. 167. 3 London Lancet, vol. i. p. 328, 1838-9; and Mr. Wright, ibid. p. 580. CREOSOTON. 175 immediately and eagerly embraced, numerous trials were instituted with it, the results of which were by no means accordant. Reich1 affirmed, that he gave it both in laryngeal and tubercular phthisis with distinguished success. In a case in which the disease ap- peared to be considerably advanced, the offensive expectoration was changed into one of a tasteless, mucous character, although the fever and the night sweats experienced no modification. Subsequently, haemoptysis supervened, with violent fever; on which account the dose of creosote was diminished. Under the use of the remedy the condition of the patient appeared to improve,—except the cough, which was not mitigated; an anodyne was consequently substi- tuted for the creosote; under which, his patient—a female—im- proved so much, that Reich was led to believe she might be saved, although the cough still remained severe and frequent. In another case, the creosote allayed the hectic fever, and transformed the purulent expectoration into one of a mucous character: yet, al- though the general condition of the patient seemed to be improved, the cough and uneasiness of the chest continued almost unchanged. Grandjean also had a case of phthisis in the third stage, the expec- toration of which was soon diminished; the pain in the side re- moved ; the appetite, sleep, and strength restored, under the admi- nistration of creosote; but the result of the case is not known. Levrat asserts, that he found creosote highly useful in chronic bronchitis, and in some kinds of phthisis. Hechenberger saw good effects from the inhalation of creosote in the form of vapour in a case of ulcerated lungs ; five, ten, or fifteen drops of creosote, ac- cording to the degree of tolerance of the lungs, being dropped into hot water in an appropriate vessel, and the vapour received through the tube of an inverted funnel. Hechenberger was of opinion, that this mode of exhibiting creosote prevented the disagreeable effects apt to be induced by its internal use; and farther experiments have confirmed his view. In the chronic mucous affections of the luno-s of old people it appears to have been especially useful. On the other hand, EUiotson2 derived no favourable results from his trials with creosote in phthisis; even inhalation of the vapour was gene- rally unattended with any advantage ; yet, he is of opinion that it may be useful where there are only one or two ulcers in the lungs, and there is no tendency to their farther production, as well as where there is much secretion from the bronchial mucous mem- 1 Hufeland's Journal, Jan. 1834; and Revue Medicale, Mai, 1834. 2 Medico-Chirurg. Transact, xix. 221; Lond. 1835. 176 NEW REMEDIES. brane. Either no advantage, or an injurious influence was derived from its use in phthisis, by Rehfeld, Haupt, Treumann, Gunther, Schmalz, Meisinger, Otto, Kohler,1 and others. The published experiments by Wolif, in the Charite at Berlin, cannot be esteemed more favourable. It was tried in eleven cases of phthisis tuberculosa, of which one was in the first, eight were in the second, and two in the third stage. In two cases, there was scarcely any advantage after the remedy had been given for four- teen days. In one case, it had to be discontinued on the eleventh day, owing to the supervention of obstinate vomiting. The case ultimately terminated unfavourably. In six cases, the symptoms appeared to be aggravated, and the patients died soon afterwards. In two cases, in which the disease was in its second stage, death supervened unexpectedly early, on the fourth and seventh day of the treatment,—in one case by suffocation; in the other, by sudden hydrothorax. The pulse, according to Wolff, was generally in- creased under its use ; the hectic augmented ; the urinary secretion diminished ; the expectoration neither changed in quantity nor quality ; the cough not mitigated ; or the dyspnoea diminished : on the other hand, they were, in four cases, manifestly increased : once epistaxis occurred, and twice hasmoptysis. From the results of all his trials, Wolff is disposed to think, that creosote should be banished from our list of agents employed in phthisis ; both as respects the radical and the palliative treatment ;a but although they may not sanction us in placing much value on creosote in the treatment of phthisis, it may be improper to ostra- cise it altogether,3 as according to the testimony of others it would seem to have rendered essential service. Rampold and Spath assert, that they have derived advantage from it in confirmed phthisis where no inflammatory complication was present;—the expectoration and colliquative sweats being diminished under its use. M. Petrequin4 from his trials with it considered its effects to be more beneficial—as might be presumed—in incipient than in con- firmed phthisis ; but in no case did he observe any thing approach- ing the radical cures described by some. He indeed gives the pre- ference to the tar water, (see Aqua Picea.) ' Hecker's neuen wissensehaft. Annal. B. i. H. 3. 2 See, also, Kohler, in Rust's Magazin, B. xlvi. and Amer. Journ. of the Med. Sciences. Feb, 1837, p. 497. 3 Riecke, Op. cit. S. 170. 4 Gazette Medicale de Paris, Nov. 1836. CREOSOTON. 177 15. In bronchorrhaa or that state of the bronchial mucous mem- brane, which consists in a profuse secretion without inflammation, the inhalation of creosote has been found of essential service.1 16. Rheumatism and Gout.—The success, obtained by Reich2 from a tincture of soot in gouty and rheumatic affections, and the probability that the efficacy might depend chiefly on the creosote it contained, induced him to prescribe this remedy internally in those diseases. He made the first trial upon himself. After exposure to cold he was attacked with lancinating pain in the whole of the right leg, for the removal of which the ordinary remedies were em- ployed in vain; it yielded to the use of creosote given for nine days. He relates another case of rheumatism and one of atonic gout, in which creosote was equally successful. Marcus, of Ha- dersleben, recommends it in cases of rheumatism, unaccompanied by excitement of the vascular system, or tendency to congestion and febrile reaction. It is proper, however, to observe, that he combined other agents with it, so that his experiments are by no means decisive as to the efficacy of the creosote. Of the three patients, to whose cases he refers, one only was cured ; the other experi- enced improvement. Karsten found none of the advantages, de- scribed by Reich in rheumatic and gouty cases, from its use. In a case of rheumatic headach, Tschepke found surprising advan- tage from frictions with creosote, and plugging the ear with cotton dipped into it. The creosote immediately excited acute pain, and some rubefaction of the skin ; and as the burning ceased, the pain ceased along with it. In Most's experience, lotions of creosote water greatly alleviated the pain of the joints in rheumatism and atonic gout. 17. In vomiting not arising from inflammation or other organic disease of the stomach, EUiotson3 found creosote very efficacious. Even in the Asiatic cholera and in sea sickness, it appeared to allay the vomiting. In various affections of the stomach, as in cardi- algia and gastrodynia, it may be found useful.4 In cases of vomit- ing from nervous excitability it has been affirmed to excel all known medicines.5 After Dr. EUiotson had recommended it, Dr. Shortt tried it in about a dozen cases, and found it equally successful, as 1 Hlliotson, in Med. Chirurg. Transact, xix. 221. Lond. 1835. 2 Uufeland's Journal, Jan. 1S34-, and Revue Mtd. Mai. 1834. a Modico-Cliirurgical Transactions, vol. xix. and Lancet, Aua 20 1M6 1 Riecke, Op. cit. S. 172. to" ' ' Cormack, Op. cit. p. 133. 23 178 NEW REMEDIES. did also Prof. A. T. Thomson of London, Dr. Bodington of Er- dington in Warwickshire, and many others. Dr. John Walker of Glasgow, in a case published by him1 does not appear however to have been equally fortunate, and with Dr. Paris it entirely failed.2 Our own success has been by no means as great as that of Dr. EUiotson. In many cases, indeed, it has developed irritability of the stomach, where it did not previously exist. Dr. EUiotson admits that in large doses it seems to excite vomit- ing, and that when given in such quantities with a view to check it, no good, but evil, results from giving a large dose. As a pre- ventive of sea sickness it has been highly extolled by Dr. EUiotson, and by Mr. A. B. Maddock.3 It has been administered also as an excitant to relieve gastrodynia and flatulence, and where hydrocyanic acid and creosote have been separately tried unsuccessfully, Dr. EUiotson recommends, that they should be combined. 18. Several portions of tania having been observed to be dis- charged after the administration of creosote, Kraus was induced to prescribe it as a powerful anthelmintic. This he did in numerous cases, and with the best success ; from five to eight drops being given to adults with oleum ricini; or where the bowels were not freely opened with half a drop or a drop of croton oil. 19. In diabetes mellitus, creosote was first given by Berndt,4 and with striking success. One or two cases of the same kind are related by Gadolin ; but Rehfeld used it without advantage. Dr. EUiotson agrees with Berndt in the opinion, that it is sometimes of use in diabetes, and may even be greatly instrumental in accom- plishing a cure.5 20. Dr. EUiotson6 tried creosote in nervous diseases. In some cases of epilepsy, the paroxysms appeared to be rendered less fre- quent and more mild; but in the generality of cases, they returned with fresh violence. In somj cases, the remedy had no influence on the disease ; in others it appeared to aggravate it. In neuralgia great advantage was at times derived from it, although, here, again, it was frequently of no service. Dr. EUiotson also observed good 1 Lancet, Dec. 19, 1835, p. 447. See also Mr. Taylor, Ibid, Aug. 15, 1835, anJ Dr. Macleod, in Lond. Med. Gazette, xvi. 598, and xvii. 653. 2 Pharmacologia, 8th edit, append. Lond. 1838, 3 Amer. Journ. of the Med. Sciences, Feb. 1838, p. 496. 4 Kleinert's Repertorium, Jan. 1835, and Lancet, July 18, 1835. 5 Medico-Chirurgical Transactions, xix. 132-135. Lond. 1835. 6 Op. cit. CREOSOTON. 179 effects from it in hysteria, where there was no inflammatory com- plication ; in spasmodic erethism of the nervous system, and in palpitation ; and Dr. Herndon,1 of Virginia, used it with much benefit as an inhalation in hysteric croup (thirty drops to the quart of hot water). In asthma, dependent upon morbid excitability of the bronchial mucous membrane, Dr. EUiotson2 found its inhalation to be often useful. 21. In two cases of chronic glanders, the same gentleman3 ac- complished a cure in the course of a few weeks, by the sedulous use of an injection of a dilute solution of creosote (gtt. 1 ad aq. §j) thrown up the affected nostril; combining the treatment, in one of the cases, with the internal use of the remedy; and a similar case of success is given in a recent number of a British medical periodical.4 MODE OF ADMINISTERING. The dose for internal use is one or two drops, given several times a day, in gum water.5 In cases of tapeworm, the dose should be larger. Some give it in emulsion, but this form is objectionable on account of the disagreeable taste. It is best administered in pill. Externally, it is at times applied pure; at others diluted,—com- monly with water, with or without the addition of spirit of wine, or in the form of ointment. Carminati6 affirms, that oil and mu- cilage, when combined with it, render it milder, but that vinegar increases its action. Dr. Cormack,7 however, doubts the assertion in regard to vinegar. In three comparative experiments, which he made with a view of testing the justice of Carminati's conclusion, there was no apparent difference in the activity of creosote when given with acetic acid or alone. He was led to believe, however, that the addition of albumen caused it to act more powerfully, which, if true, is singular. The inhalation of creosote vapour may be accomplished by dif- 1 Amer. Med. Intelligencer, Mar. 15, 1838, p. 425. 2 Op. cit. s Lancet, for June 20, 1833. 4 Ibid, Jan. 20, 1839, p. 145. 5 It may be well to remark, that the fluidram contains one hundred and fifty drops of creosote. 6 Op. citat. 7 Op. citat. p. 88. 180 NEW REMEDIES. fusing a few drops of creosote through water, or a mucilaginous liquid, in an ordinary inhaling vessel, or in the mode described under the head of Chlorine.1 Pilula Creosoti. Pills of Creosote. ^. Creosot. £j. Succ. glycyrrhiz. Gum. galban. aa. £ss. Pulv. lad. althaea;, gij. Fiat massa in pilulas cxx. dividenda. Dose.—Six pills four times a day. In consumption. Reich. fy. Creosoti, Succ. liquirit. aa. 51. Pulv. rad. althseae, £ij. Fiat mass, in pil. cxx. dividend. Dose.—Five pills morning and evening, in atonic gout. Reich. Haustus Creosoti. Creosote Draught. 5«. Creosot. n\,. iv ad x. Misturae camphorae, Infus. gentian, compos, aa. f. £vj. M. fiat haustus. Brande.2 Mistura Creosoti. Mixture of Creosote. *. Creosot. gtt. v. Mucilag. gum. arab. §iij. Syrup, althaeas, § j. M. Dose.—A spoonful every three hours in haemoptysis. Santini. Tinctura Creosoti pro Gingivis. Tincture of Creosote for the Gums. &. Creosot. &j. Spiritus vini rectificati, ^ij. M. 1 See page 107. ** Dictionary of the Materia Medica, p. 201. Lond. 1839. CREOSOTON. 181 As much of this to be added to cold water as is necessary to give it a piquant taste, with which the teeth may be washed and the mouth rinsed. Used in cases of fcetor of the mouth from carious teeth, and to limit the caries. Buchner. g<. Creosot. Alcohol, aa. gss. M. To be applied to carious teeth. Radius. 5<. Creosot. p. i. Alcohol, p. viij. M. This is the ordinary strength of the tincture. Used where frac- tions of a drop of pure creosote are prescribed. Lotio Creosoti. Lotion of Creosote. g<. Creosot. jss. Aquae destillat. gv. M. Used as a lotion in impetigo sparsa and itch. Wolff. The author has occasionally found a lotion composed of f. 3ss of creosote to Oj of water too irritating. &. Creosot. gtt. xij. Aq. destillat. gij. M. To be applied by means of a hair pencil twice a day to inflamed eyelids. Coster. 91. Creosot. gtt. iv. Aq. destillat. gij. M. In irritation of the gums. Fremanger. 5<. Creosot. gss. Gum. arab. giss. Aquae camphor, gxss. M. Used every two hours in cases of aphthous ulceration of the mouth. Magendie. £. Creosot. gtt. x. Aceti, 3ij. Aquae fontis, ^ij. M. 182 NEW REMEDIES. Used in cases of phagedenic ulceration, and to chancres ; appiled by means of a camel's hair pencil. Shortt.1 Unguentum Creosoti. Ointment of Creosote. St. Cerati, 01. amygdal. dulc. aa. $j. Creosot. gtt. xxx. M. A dressing in scrofulous caries. Fremanger. The Unguentum Creosoti of the London Pharmacopoeia is com- posed of half a fluidram of creosote to an ounce of lard.2 Linimentum Creosoti. Liniment of Creosote. g<. Creosot. gtt. v. — xx. 01. olivar. §ss. M. To be rubbed two or three times a day on the diseased parts, in chronic herpes. Corneliani. cubeba. Synonymes. Piper Cubeba, P. Cubebarum, P. Caudatum, Cubebs. French. Poivre a queue, Cubebe. German. Kubebenpfeffer, Schwanzpfeffer. Cubebs are the fruit of the piper cubeba, which grows in India, Java, Guinea, &c. Sex. Syste?n, Diandria Trigynia ; Nat. Ord. Piperaceae. The corns of this plant have been long known in the shops; and in the old Wirtemberg Pharmacopoeia, they figure as calefacient, inciting, discutient, antinervous, and carminative agents, which seem to have a specific action in vertigo; hence they ob- tained the name "Schwindelkorner" or "grains for vertigo." They had however fallen into oblivion, until they were re-introduced in modern times into practice, especially by the English physicians and surgeons. The shell of the dried berry has a weak taste, but smells agree- 1 Cormack, Op. cit. p. 112. 2 Brande, Op. cit. p. 202. CUBEBA. 183 ably; the kernel has a bitter aromatic flavour which is biting at first, but afterwards cooling. The corns were analysed by Tromms- dorf and by Vauquelin ;l but the most recent analysis is by Monheitn.2 He found, in 100 parts, of lignin 64.0 ; of extractive matter 6, of Kubebin 6, of a matter like wax 3, of green volatile oil 2.5; of yellow volatile oil 1.0, of balsamic resin—which, accord- ing to Vauquelin, is very analogous to the balsam of copaiba—1.5, and of chloride of sodium 15.5. [?] The woody matter reduced to ashes contained much carbonate and muriate of potassa and soda. The kubebin appeared to Monheim to be identical with the pipe- rine, but to be united with an acrid soft resin. EFFECTS ON THE ECONOMY. In addition to the general excitant properties of the peppers, the action of cubebs is exhibited on the urinary and genital organs. Under their use, the secretion of urine is augmented, and it becomes of a darker colour, and assumes an aromatic odour. Cubebs have been advised, in modern times—;first, in cases of gonorrhea, in which they have been esteemed a specific by many. Yet that which applies to the copaiba is equally applicable to the cubebs. Although the revulsive effect induced by both on the kidneys may mitigate the inflammatory condition of the lining membrane of the urethra, which constitutes gonorrhoea—in violent inflammatory cases, and in the early stages of ordinary cases, they may be inju- rious, and there are many cases on record in which bad conse- quences appear to have resulted from their improper administration. Still, there are many physicians who administer both them and the copaiba in every stage of the disease. Of 50 patients, treated by Mr. Broughton3 by the cubebs, 10 were cured in from 2 to 7 days; 17 in from 8 to 14; 18 in from 15 to 21 ; 1 on the 55th day ; and in 4 only was no success obtained. In the chronic stage of gonorrhoea, M. Ricord4 prescribes the cubebs in combination with the peroxide of iron, and in addition the patient is directed to inject, four times a day, a solution com- posed of aq. destillat. §viij. argent, nitrat. gr. ij. It has been affirmed, that different evils have ensued from the use 1 Memoir, du Museum, vi. 225. 2 Riecke, Die neuern Arzneimittel, S. 176. 3 Medico-Chirurgical Transactions, xii. 1. Lond. 1822. 4 La Lancette Francaise, IVo. 33. Paris, 1838. 184 NEW REMEDIES. of cubebs; which ought to suggest care in their administration: for example,—ardor urinte, fever, inflammation of the urethra, blad- der and testicles, retention of urine, cutaneous eruptions, &C.1 In the blennorrhoea of females the cubebs are equally extolled by many practitioners, as well as in leucorrhoea.2 Secondly, Spitta found them very efficacious in old and obstinate cases of coryza, when given in the form of lozenges : they are said, likewise, to have been administered with advantage in defective audition, caused by a catarrhal affection of the Eustachian tube. Thirdly. Rosen found the chewing of cubebs very serviceable in cases of aphonia. Fourthly. They have been prescribed successfully in cases of chronic rheumatism. Fifthly. Pul3 gave them with striking ad- vantage in intermittent fever. Sixthly. In India, they are re- garded to be aphrodisiac.4 According to Dr. Paris, it is important to keep the bowels open during their use, for when hardened fasces are allowed to accumu- late, the spice insinuates itself into the mass, and occasions exco- riations in the rectum.5 MODE OF ADMINISTERING. Cubebs are commonly given in the form of powder, and in doses of from 1 to 2 and even 4 drams, repeated once or oftener in the day. Lozenges, boluses, and electuaries, are likewise prepared of them, and by some a tincture has been recommended. In conse- quence of the disorder at times induced by them in the digestive function, Velpeau proposed that they should be given in the form of glyster, to the amount of one or two drams of the powder, sus- pended in five or six ounces of an oily vehicle, and this method has its advantages.6 To attain the same object, M. Dublanc, Junr., prepared an oleo-resinous extract, one-sixteenth part of the weight of which possessed equal virtues with one part of the cubebs; five grains, three times a day, acting like the ordinary quantity of the powdered cubebs.7 1 Lond. Med. and Physical Journal,* Mar. 1832, and Merat & De Lens Diet. Univers. de Matiere Medicale, &c. Art. Piper Cubeba. 2 Edinb. Med. and Surg. Journal, xviii. 3L9. 3 Recueil de Med. Chirurg. et Pharm. Militaire, xvi. 4 Merat & De Lens, Art. cit. 5 Brande, Dictionary of Materia Medica, p. 205- Lond. 1839. 6 Archives Generates de Medecine, xiii. 47. 7 Journ. de Chimie Medicale, iii. 491, and Journ. de Pharmacie, xiv. 40. CUBEBA. 185 Electuarium Cubebarum. Electuary of Cubebs. 5<. Piper cubeb. pulv. §ss. Mellis despum. q. s. Fiat electuarium. Dose.—A tea-spoonful three or four times a day, in Catarrhus vesicae, C. urethras, &c. Radius. Be. Balsam, copaib. givss. Subige cum Vitello ovi unius, et Adde Pulv. cubebar, givss. Conserv. rosar. ^ss. M. fiat electuarium. Dose.—A tea-spoonful three or four times a day. Vogt. St. Balsam, copaib. Pulv. cubeb. aa. §ij. Aluminis, 3j. Extract, opii, gr. v. M. Dose—A dram night and morning in the pulp of a prune. The quantity may be rapidly increased to two drams morning and evening. Trochisci Cubebarum. Lozenges of Cubebs. St. Pulv. cubeb. ^ij. Balsam, tolut. gr. vj. Admisce Syr. balsam, peruv. Succ. glycyrr. aa. 3j. Gum. arabic. q. s. ut fiat massa in trochiscos pond. gr. x. dividends. Used in coryza. Spitta. Boli Cubebarum. Boluses of Cubebs. St. Balsam, copaib. Gum. arab. pulv. aa. gij. Aquoe flor. aurant. 9ij. Terendo bene mixtis adde Cubebai. pulv. 3ij. Misce, et fiant boli No. vj. D0SQ—One, three times a day. Uenschel. 21 186 NEW REMEDIES. M. Labelonye1 has recently proposed the following method for separating all the principles of the cubebs from the ligneous matter. The cubebs, reduced to a coarse powder, are placed in an appa- ratus for displacement and exhausted by ether, which dissolves the wax, volatile oils and balsamic resin. The residue is submitted to the action of hydro-alcohol at 20° (.935), which dissolves the ex- tractive principle and chloride of sodium. The alcohol and ether are separated by distillation in part, and separately. Evaporation of the hydro-alcoholic solution is then carried on in a water bath until it possesses the consistence of a soft extract, to which the ethereal product is added ; the evaporation being continued for a short time, the ether is completely volatilised, and a strongly aro- matic extract is obtained, as consistent as honey. This it is im- proper to subject any longer to the action of heat, on account of the contained volatile oils; the presence of which in all cases interferes with complete desiccation. One part of this extract is conceived to be equal to five of the cubebs. This extract can be readily mixed with water by means of mu- cilage, and can be administered in potions, injections, &c. The best form of exhibition, according to M. Labelonye is in lozenges, or in an emulsive syrup. Trochisci Extracti hydro-alcoholici atherei Cubebarum. Lozenges of the ethereal hydro-alcoholic Extract of Cubebs. 3<. Ext. hydro-alcohol, aether, cubebar. §viij. Alcohol, Oij. Solve et adde Sacchar. alb. in pulv. ten. ftj. 01. mentha? pip. gtt. xviij. Pour the mixture into flat vessels upon a stove, and allow the alcohol to evaporate at a moderate heat. When the mass is com- pletely desiccated, reduce it to fine powder, and add a sufficient quantity of mucilage of gum tragacanth to form lozenges—18, 12, 9, or 6 grains each. Most persons, he says, can swallow with facility those weighing eighteen grains, and containing six grains of the extract; ten of these are equivalent to half an ounce of the powder. 1 Bulletin General de Therapeutique, and Amer. Journ. of Pharm. 2d series, vol. 2. p. 316. Philad. 1837. delphinina. 187 Syrupus Extracti hydro-alcoholici atherei Cubebarum. Syrup of the ethereal hydro-alcoholic Extract of Cubebs. St. Ext. hydro-alcohol, aether, cubebar. ,§iij. Suspende ope mucilaginis in Aq. menthae pip. ftj. Adde Sacchar. alb. B>ij. M. Four ounces of this syrup contain two drams of extract, equi- valent to ten of powdered cubebs. Dose—A tea-spoonful. M. Labelonye, envelopes the extract also in sugar, as in the ordi- nary sugar-plumb. DELPHININA. Synonymes. Delphininum, Delphininium, Delphinia, Delphium, Delphia, Delphinine, Delphine. German.—Delphinin. This alkaloid was discovered in 1819, by MM. Feneulle and Lassaigne,1 and, almost at the same time, by Brandes,2 in the seeds of the Delphinium Staphisagria, in which it is united with acetic acid. As a therapeutical agent, it has been chiefly recommended by Turnbull; but he did not employ it in its pure state. METHOD OF PREPARING. » The plan recommended by Magendie3 is to boil a portion of the seeds of the delphinium, cleared of their coverings, and reduced to a fine paste, in a little distilled water; to pass the decoction through a linen cloth and filter. Pure magnesia is now added, and it is boiled for some minutes ; the filtration is repeated ; and the resi- dues washed carefully and digested in highly rectified alcohol. On evaporating the alcoholic tincture, the delphinine is obtained in the form of a white powder, having some crystallised points. 1 Annates de Chimie, torn. xi. xii. and Journal de Pharmacie, vi. 47 and 366. 2 Schweigger's Journal der Chimie, xxv. 369. 3 Formulaire, &c. 188 NEW REMEDIES. This is esteemed the most simple mode ; but if a large quantity be required, the following plan is advised—on account of the time and patience necessary to decorticate the seeds. Submit the uncleaned seeds, when well bruised, to the action of weak sulphuric acid. Precipitate the liquor by ammonia, and re- dissolve in alcohol the delphinine, which is still slightly coloured. To purify it, draw off the alcohol by distillation, dissolve the resi- duum in muriatic acid, and boil with magnesia. The plan recommended by Couerbe, and adopted by Turnbull,1 is to evaporate a saturated tincture of the seeds to the consistence of a thin extract, and then to treat it with water acidulated by sul- phuric acid. This solution, when filtered, is to be precipitated by ammonia. The precipitate—after being freed from its water—is to be taken up with alcohol, and again reduced to the consistence of an extract, which is likewise to be dissolved in acidulated water ; to this solution, filtered, a small quantity of nitric acid is to be added, as long as any precipitate is thrown down. The liquid, freed from this precipitate, is again to be subjected to precipitation, by ammonia, and the powder dried. This is the delphinine of commerce; but like veratrine, it is a compound substance, and consists of resinous matter, staphysagrine and delphinine; the delphinine is obtained by treating the powder with ether, which takes up the delphinine, and leaves the staphysagrine. When in a state of purity, delphinine is white, pulverulent, and devoid of smell; but like veratrine, when applied to the mucous membrane of the nose, it occasions sneezing, along with an abun- dant secretion of mucus. Its taste is at first bitter, and afterwards acrid, and it acts upon animals in the same manner as—but more energetically than—the seeds whence it is prepared. It is very sparingly soluble in water, but yet in sufficient quantity to com- municate a bitter taste to the fluid. In alcohol and ether it dissolves readily, and these solutions have the property of rendering syrup of violets green, and of restoring the blue colour of litmus, when reddened by acids. It combines readily with acids, and forms neutral salts, which are possessed of much bitterness and acridity, and it may be precipitated from solutions of these in the form of a jelly by the addition of an alkali. 1 On the Medical Properties of the Natural Order Ranunculacese, chapter 2. Lond. 1835. DELPHINTNA. 189 EFFECTS ON THE ECONOMY. From the experiments of Orfila1 with this substance, it appears to belong to the class of acro-narcotic poisons. In the dose of about five grains it proves fatal to dogs; and the fatal result is more speedily induced when the delphinine is dissolved in weak acetic acid; the animal, in the latter case, dies in the space of from forty to fifty minutes. When diffused through water introduced into the stomach of a dog, and retained there by a ligature placed around the gullet, efforts to vomit supervened, with restlessness, giddiness, immobility, slight convulsions, and death in two or three hours. In this case, the mucous membrane of the stomach was generally found injected. From his administration of delphinine and its salts, Turnbull concludes, that the pure alkaloid has little effect on the mucous membrane of the stomach and bowels. It may be given, he says, in some cases, to the extent of three or four grains a day, in doses of half a grain each, without exciting vomiting; in this quantity, however, it sometimes operates upon the bowels, but causes very little irritation. In most instances it acts as a diuretic, and occa- sions a considerable flow of pale urine. When taken to the extent of a few grains, it induces heat and tingling in various parts of the body, similar to those produced by rubbing it upon the skin ; and its other effects are very nearly the same as those of the salts of veratrine. The preparations of delphinine have been used in the same diseases as those of veratrine, and they appear to exert a similar action : the test laid down by Turnbull, in the case of the veratrine, applies equally to the delphinine;—namely, that unless a solution of delphinine in alcohol, in the proportion of four grains to a dram, occasions a distinct sensation of heat and pricking, when rubbed for three or four minutes on the forehead, the specimen ought not to be used, as no beneficial effect would arise from its application. When rubbed upon the skin, it gives rise to a sensation of burning, not unlike that which manifests itself a short time after the appli- cation of a blister, but not to an unpleasant degree, unless the fric- tion has been carried too far. The effects of the delphinine differ also from those of the veratrine in being generally more powerful and durable. The diseases in which the delphinine has been chiefly used, like ' Nouveau Journal de Med. x.; and Toxicologie Gen. i. 739. 190 NEW REMEDIES. the veratrine, are—tic douloureux, paralysis, and rheumatism. In the first of these, when the affection is seated in the tongue, or at the point where the infra-orbitar nerve escapes from its foramen, the use of delphinine, according to Turnbull, is to be preferred, because it can be applied to the tongue, or rubbed on the gums, without occasioning irritation of the mucous membrane. He thinks it, also, upon the whole, better adapted for the treatment of paralytic cases than veratrine, but principally on account of the property it has " of exciting the circulation in the diseased part." MODE OF ADMINISTERING. The manner of applying delphinine is the same as that recom- mended for veratrine. It may be used either in the form of oint- ment or in solution in alcohol, and the proportions to be employed, in either case, may vary from ten to thirty or more grains to the ounce, according to the severity of the affection, for the treatment of which it is prescribed. The duration of the frictions should also be the same, or until the pungent sensation, produced by the rubbing, exhibits itself. DIOSMA CRENATA, (FOLIA.) Synonymes.—Barosma Crenata, (folia;) Agothosma Crenatum (folia;) Bocchoe, Bocho, Boocho, Buchu Leaves. German.—Buccublatter; Duftstrauchblatter. This plant is indigenous at the Cape of Good Hope. It belongs to the natural family Rutaceee ; class Pentandria, order Mono- gynia. The smell of the leaves is penetrating and peculiar, but re- sembling that of rue and camphor. By some, it has been com- pared to that of the oil of juniper. The name appears to be derived from the smell,—hot, " divine," and o«r^, " odour." The taste of the leaves is aromatic, somewhat pungent, and, in the opinion of Buchner, resembling that of peppermint; without any particular bitterness, yet disagreeable. According to the analysis of Buchner, the most important constituents appear to be a volatile oil of a greenish yellow colour, a peculiar principle—diosmine, and a semi- DIOSMA CRENATA. 191 resinous substance. The diosmine is a very tenacious adhesive matter, similar to the Peruvian balsam, and can be drawn out in fine threads. It has the same smell as the leaves, only somewhat weaker; the taste is pungent and bitter. The semiresinous matter has a resinous lustre; is of a dark brown colour, becomes fluid when heated, and burns with a flame. Its odour is not remarkable: the taste is somewhat pungent and sourish.1 EFFECTS ON THE ECONOMY IN HEALTH. The Hottentots have long used the leaves of several varieties of diosma both internally and externally; but they give the preference to the diosma crenata. Through them its virtues became known to the European settlers. It was first brought to the notice of Bri- tish practitioners by the notorious Richard Reece, who is more known for the part he took in the farce of Joanna Southcoat than for any thing else. In Germany, it was chiefly promulgated by Jobst, who published an extract from Reece's observations in the Repertorium of Buchner.2 Bardili instituted experiments for testing the action of the remedy on the healthy organism. It first acts as an excitant on the sto- mach, whence arises a feeling of increased heat in that organ, and the appetite becomes augmented ; from the stomach, the excitement spreads to the vascular system; the heat of the body is increased; the pulse becomes more frequent, and the transpiration is favoured. It acts, likewise, on the urinary secretion ; the urine is separated in larger quantity, contains flocculi, deposites a purulent (?) sediment, and exhales an aromatic odour. On the digestive function, it seems to produce somewhat of a constipating effect. Bardili thinks, that he has also witnessed some narcotic operation in his experi- ments. The same results were produced by the diosma on animals. EFFECTS ON THE ECONOMY IN DISEASE. The inhabitants of the Cape administer this agent as a stomachic, and the Dutch physicians give it with success in indigestion. It is said, also, to have afforded essential service in chronic cases of 1 See Journal de Chimie Medicale, iii. 13, and Journal de Pharmacie, xiii. 106. 2 Band. xxii. S. 51. 192 NEW REMEDIES. rheumatism and arthritis. Autenrieth extols it in rheumatic pains, which have had their foundation in repelled itch ; and its utility in chronic rheumatism has been confirmed by Jackson and others. It has been extolled, moreover, in hasmaturia, calculous pains, and in irritated and suppurative conditions of the bladder, urethra, and prostate. We have repeatedly administered it, but have observed no other effects than those of a moderate excitant and tonic. Reece found it efficacious in incontinence of urine, and in catarrhus vesicae ; and he gave it—united with tincture of cubebs—in spas- modic stricture of the urethra, gonorrhoea, swellings of the pros- tate, and impotence. By the inhabitants of the Cape of Good Hope, the buchu leaves are often applied externally, both in the form of liniment and of baths, in luxations and rheumatic pains,—as well as of fomenta- tions and cataplasms, in wounds, especially the contused. It may be remarked, that this—like almost every similar remedy —has been given in cholera; and the Riga physicians assert, fre- quently with favourable results. MODE OF ADMINISTERING. The dose of the powder is 3ij in the day; this, at least, is the common dose at the Cape. The infusion necessarily contains more of the volatile oil than the decoction; but, on the other hand, the latter has more of the diosmine: as respects their action, however, there is not much difference. A vinegar, oxymel, liniment, extract, and tincture of the diosma have been advised. The Dublin Pharmacopoeia has an infusum buchu, (gss of the leaves to fbss of water); dose giss: and a tinctura buchu (§ij of the leaves to fbj of proof spirit); dose £ij or 3iij. Infusum Diosma Crenata Compositum. Compound Infusion of Buchu. St. Fol. diosm. crenat. ----uvae ursi, aa. |jss. Aq. fervid. §viij. Digere leni calore in vase clauso per semihoram. Colaturse adde Syrup, seneg. §ss. Dose.—One or two spoonfuls every two hours, in blennorrhoea, and in atony and paralysis of the bladder. Clarus. ELECTROPUNCTURA. 193 ELECTROPUNCTURA. Synonyme.—Electropuncture. This consists in a union of acupuncturation with electricity. The idea of the conjunction appears to have originated with Ber- lioz ; but Sarlandiere was, doubtless, the first who put it in practice, although J. Cloquet has contested the priority with him—a matter, by the way, as in all such cases, of extremely small moment. The operation consists in employing acupuncturation in the usual way, either with a single needle, or with two or more; and making a communication between them and the prime conductor of an elec- trical machine; or they may be made to form part of the circuit in the discharge of a Leyden jar. In this way, the electrical influence may be graduated from the simple aura to a full shock. Sarlandiere appears to have employed electropuncture with great success, but he restricts its use to rheumatic or neuralgic pains, uncomplicated with organic mischief or inflammation : when such complications exist, he advises bloodletting and general antiphlogistics to be pre- mised.1 Guersent thinks it better, in all these cases, to use simple acu- puncturation, and only to employ electropuncture, when the first proves to be inadequate, as in paralysis, and in tremors produced by the immoderate use of mercury ;—in all cases, indeed, in which the malady depends on a diminution of the nervous energy. A case of success from its use, in paralysis of the right arm, in which volun- tary motion and sensibility were destroyed, has been recently pub- lished.2 The patient was, in the first instance, subjected to the use of blisters and moxas along the course of the radial nerve, from which he obtained some advantage. The remedy which succeeded best, however, was electropuncture along the nerves from the shoulder to the hand. At first, the punctures were but little felt, but afterwards they were very painful. The sensibility, mobility, and strength of the fingers and hand gradually returned ; and, three months after his admission, the patient left the hospital com- pletely cured. Magendie affirms, that he has treated many cases of incomplete 1 E. Grafe, Art. Electropunctura, in Encyclopad. Worterb. der medi- cinisch. Wissensch. x. 550. Berlin, 1834. 2 La Lancette Francoise, Dec. 20, 1836; and American Med. Intelli- gencer, Oct. 16, 1837, p. 265. 25 194 NEW REMEDIES. amaurosis with great success by this agency. He employed it, however, in the form of what has been more properly termed gal- vanopuncture ; by fixing a needle in the frontal nerve, and another in the superior maxillary, and making these communicate respec- tively with the poles of a galvanic pile of twelve pairs of plates, each six inches square. Whenever the contact was made, the pa- tient experienced a painful commotion in the course of the nerves, and at the bottom of the orbit; the light became better appreciated, and the pupil contracted. We have frequently used both electropuncture and galvano- puncture in rheumatic and neuralgic affections; but do not think the advantages were more marked than those of simple acupunc- ture, whilst the suffering from the operation was certainly greater. In cases of asphyxia, galvanopuncture has been proposed to arouse the dormant energies. The effect of electricity, in the dif- ferent forms in which it is adopted in medicine, on the functions of sensibility and muscular contraction, could not fail to suggest it early to observers as a fit agent for this purpose; but it is rarely at hand, and, therefore, seldom available. J. P. Frank, Thillaye,1 and others have highly recommended it;—the latter gentleman, on the strength of numerous experiments on animals. As the object, in these cases, is to arouse the respiratory muscles to action, the electric shock may be passed through the shoulders or the chest in any direction. Neither common nor galvanic electricity is possessed of any power to restore the action of the involuntary muscles. We have frequently attempted to re-excite the action of the heart, in- testines, fibres of the uterus, &c. soon after the cessation of re- spiration and circulation, by means of the galvanic stimulus, but without the slightest success, although the voluntary muscles re- sponded to it energetically. Besides, were the action of the heart re-excited by it, this could be but momentary. A necessary stimu- lating agency to that viscus is distension by the proper fluid, and unless the respiratory movements were restored, and conversion of venous to arterial blood effected, so that the latter could reach the left heart, the action of that organ could not be maintained. Every attempt, therefore, is properly made to restore the action of the respiratory muscles, so that hsematosis may be accomplished.2 1 Archives Generates de Medecine, xii. 2 Art. Asphyxia, by the author, in the American Cyclopaedia of Practical Medicine, part x. p. 486, Sept. 1836. ELECTROPUNCTURA. 195 M. Leroy d'Etioles1 has suggested galvanopuncture in a manner which, at the first aspect, appears most formidable; but which is really less so than it seems to be, in consequence of the impunity with which fine needles can be made to penetrate, as we have seen,2 even the most important organs. He introduced an acupuncture needle on each side between the eighth and ninth rib, until it reached the fibres of the diaphragm. He then established a gal- vanic current between the needles by means of a pile of twenty-five or thirty pairs of plates, an inch in diameter. The diaphragm im- mediately contracted, and an inspiration was accomplished. He then interrupted the circle, when the diaphragm, urged by the weight of the abdominal viscera, and aided by gentle pressure made on the abdomen by the hand, returned to its former position, and an expiration was effected. In this way, the two respiratory acts were made to succeed each other, and regular respiration was reinduced. A continuous current was likewise employed in some cases, but the respiratory movements were irregular, and nothing like natural respiration resulted. Leroy tried his method on animals asphyxied by submersion, and when they had not been under water more than five minutes, they were often restored. These experiments were witnessed by Magendie.3 On different occasions, M. Leroy asphyxied animals of the same kind, and ap- parently of the same strength, and whilst those that were left to themselves perished, those that were treated by galvanism reco- vered. As an aid, therefore, to pulmonary insufflation, and an important one, galvanism, combined or not with acupuncturation, might be advantageously employed in asphyxia, but as has been already re- marked, it can rarely be available. Certainly no time should be lost in adopting the other energetic and indispensable measures that are demanded.4 It has been recommended, that as only a very small apparatus is necessary, batteries, consisting of a few plates, might be kept wherever there are station-houses for the reception 1 Magendie's Journal de Physiologie, torn. vii. 1827; torn. viii. and torn. ix; also Recberches Experimentales sur PAsphyxie, Paris, 1829; and Bourgeois, Observations sur la possibility du retour a la vie dans plusieurs cas d'Asphyxie. Paris, 1829. 2 See Art. Acupuncture. 3 Journal de Physiologie, ix. 4 See Art. Asphyxia, Op. cit. p. 486. 196 NEW REMEDIES. of persons in a state of asphyxia.1 The suggestion is good ; and they might also with propriety form a part of the cabinet of appa- ratus of the private practitioner ; but whilst an assistant is preparing the apparatus for action, the practitioner should be assiduously engaged in applying other means of resuscitation.2 EMETINA. Synonymes. Emetinum, Emetia, Emeta, Emetine. German.—Emetin, BrechstofF. In the year 1817, MM. Pelletier and Magendie,3 by a series of chemical and physiological experiments, discovered, that the various kinds of ipecacuanha are indebted for their emetic properties to a peculiar substance to which they gave the name Emetine. This substance possesses the emetic power in a very concentrated state, and has neither the disagreeable smell, nor the nauseous taste of the ipecacuanha. They considered, therefore, that it might be advantageously substituted for ipecacuanha on all occasions. There are two varieties of the active principle—the coloured and the pure, which, as Magendie remarks,4 bear the same relation to each other as moist sugar does to the white and crystallised. Ipe- cacuanha, derived from the cephaelis ipecacuanha, contains the most emetine. Emetine has been received into many of the Pharmacopoeias, as the Parisian, Batavian, Hannoverian, (fee. MODE OF PREPARING. 1. Coloured Emetine.—Powdered ipecacuanha is digested with ether at 60° (.720) to dissolve the fatty matter, whence it derives its disagreeable odour, and which possesses no emetic virtue. When 1 Kay, in Edinb. Med. and Surg. Journ. xxix. and in his work on Asphyxia. Lond. 1834. 2 See Most, Art. Galvanismus, in Encyklopad. der gesammten medicin. und chirurgisch. Praxis, u. s. w. 2te Auflage. Leipz. 1836. 3 Journal de Pharmacie, iii. 145, and Magendie's Formulaire pour la pre- paration de plusieurs nouveaux medicamens, &c. * Op. cit. EMETINA. 197 the powder yields nothing more to the ether, it is exhausted by means of alcohol, the alcohol is then evaporated in a water-bath, and the residue is dissolved in cold water. It thus loses some of the wax, and a little fatty matter, which still adhered to it; it is then only necessary to mix it with the carbonate of magnesia, whereby it loses its gallic acid,—to redissolve it in alcohol, and to evaporate to dryness. By a similar process, M. Boullay obtained from the roots, leaves, flowers, and seeds of the viola odorata, an active, alkaline, bitter and acrid principle, similar to emetine from ipecacuanha, which he denominates emetine of the violet, indigenous emetine ox violine. According to Orfila, it possesses highly poisonous qualities.1 2. Pure emetine.—This is obtained by substituting calcined magnesia, for the carbonate used in the process just described, in such quantity, that the acid existing in the liquid may be neutral- ised, and that which is associated with the emetine be separated from it. The precipitate of magnesia and emetine must now be washed with a little very cold water, to remove the colouring matter, which is not combined with the magnesia; and after being carefully dried it must be treated with alcohol, which dissolves the emetine. The emetine, obtained by the evaporation of the alcohol, must then be dissolved in a dilute acid, and treated with pure animal charcoal. After this purification, the emetine must be precipitated by a salifi- able base. The waters, used to wash the magnesian precipitate, still contain emetine, which may be separated by a second series of operations. Coloured emetine appears in the form of reddish brown, trans- parent scales; is almost inodorous, and of a bitter, but not nau- seous taste. It can withstand the heat of boiling water without experiencing change; is very deliquescent, soluble in water, and not crystallisable. Pure emetine has a white and frequently a somewhat yellowish appearance; is pulverulent, and does not deliquesce, like the former, in the air. In cold water, it is but little soluble ; more so in warm. In ether and alcohol it dissolves readily. Its taste is feebly bitter. It has an alkaline reaction, is dissolved by all the acids—diminishing their acidity, but without wholly neutralising them. With the acids it forms crystallisable compounds, from which 1 Journal de Pharmacie, Janvier, 1824. 198 NEW REMEDIES. it may be precipitated by galls, which are the best agents for ob- viating the effects of emetine, when given in too large a dose. EFFECTS ON THE ECONOMY IN HEALTH. According to Magendie,1 from half a grain to two or three grains of coloured emetine given to dogs and cats, excited vomiting, at times followed by a long sleep. In larger doses, ten grains for ex- ample, it occasioned, in dogs, repeated vomiting, after which the animal fell asleep, and generally died in twenty-four hours. On dissection, violent inflammation was found in the lungs, and in the mucous membrane of the stomach and bowels throughout their whole extent. The effects were the same when the emetine was injected into the jugular vein, or absorbed from any part of the body. In a healthy man, two grains of coloured emetine, taken fasting, produced repeated vomiting, to which succeeded decided disposition to sleep. Even a quarter of a grain at times induced nausea and vomiting. It acted also on the bowels. The effects of pure emetine are analogous, but more powerful ; two grains were sufficient to kill a strong dog. EFFECTS ON THE ECONOMY IN DISEASE. The same effects are induced on the morbid as on the healthy economy. Magendie recommends the administration of the coloured eme- tine—as the pure is much too dear—in every case where it is desirable to excite vomiting, and especially where ipecacuanha is indicated. It has not, however, been much used, except by Ma- gendie himself. Lerminier, who prescribed it, says that one or two grains of coloured emetine are equal in strength to from ten to twenty of ipecacuanha ; but that he observed no difference in their operation. The obvious advantages it possesses are—the convenient and agreeable form under which it maybe administered, and the circumstance, that several spurious sorts of ipecacuanha are frequently passed off in commerce, and occasion, in consequence, considerable disappointment in the mind of the practitioner. The employment of the active principle of course precludes these incon- veniences.2 ' Op. citat. 2 Clinique Medicale, vol. i. Paris. 1823. UMET1NA. 199 Prollius, of Wolfhagen, has frequently administered the pure emetine, which he recommends as a substitute for ipecacuanha, on the grounds above mentioned; and he properly adds, that the price is not a matter of so much moment as it might seem to be by reason of the very small quantity required to produce the desired effects. MODE OF ADMINISTERING. To produce vomiting, three grains of the coloured emetine may be dissolved in any vehicle, and given in divided doses, at short intervals. Of the pure emetine, Magendie found, in a man eighty- five years of age, one sixteenth of a grain sufficient to induce vo- miting. He remarks, however, that the man was easily made to vomit. Prollius found the medium dose of the pure emetine, for an adult, to be from two sixteenths to three sixteenths of a grain ; sometimes it was requisite to give another sixteenth. Very rarely was it necessary to give more than four sixteenths, or one fourth of a grain. As, on account of its sparing solubility, pure emetine, when given alone, might be restricted in its operation, Prollius adds an equal portion of tartaric acid and a little sugar. Mistura Emetina Vomitoria. Emetic Mixture of Emetine. St. Emetin. colorat. gr. iv. Infus. fol. aurant. gij. Syrup, flor. aurant. ^ss. M. Dose.—A dessert-spoonful every half hour; to excite vomiting. Any simple distilled water and syrup may be substituted for those of the orange flowers. Magendie. Pastilli Emetina Pectorales. Pectoral Lozenges of Emetine. 9(. Emetin. colorat. gr. xxxij. Sacchar. alb. §iv. Mucilag. q. s. ut fiant pastilli, pond. gr. ix sing. These lozenges are commonly coloured red, to distinguish them from those of ipecacuanha. A little carmine may be added for this purpose. Given in cases of catarrh, hooping-cough, chronic diarrhoea, &c. Dose.—One pastile occasionally. Magendie. 200 NEW REMEDIES. Pastilli Emetina Vomitorii. Emetic Lozenges of Emetine. St. Emetin. colorat. gr. xxxij. Sacch. alb. §ij. Mucilag. q. s. ut fiant pastill. pond. gr. xviij. Dose.—One of these lozenges taken fasting is generally enough to make a child vomit: three or four are required for an adult. Magendie. Mistura Emetina Purificata Vomitoria. Emetic Mixture of Purified Emetine. St. Emetin. purif. in pauxil. acid. nitr. solut. gr. j. Infus. flor. tiliae, 3iij. Syrup, althsece, §j. M. Dose.—A dessert-spoonful to be given every quarter of an hour, until vomiting is induced. Magendie. EUPHORBIA LATHYRIS. Synonymes.—Cataputia Minor, Lathyris, Tithymalus Latifolius, Caper Spurge, Garden Spurge, Mole Plant. The oil of this plant, which is indigenous in France, and is monoecious, has been recently recommended in medicine. Although the euphorbia is not a native of this country, it is sometimes met with in situations where it has the appearance of growing wild. It is easily cultivated, and in some parts of New Jersey, where it has been introduced, is found in abundance.1 The oil, obtained from the seeds, resembles in colour the oleum ricini, but is less dense. It has no odour when newly prepared, and no perceptible taste. It is soluble in sulphuric ether, insoluble in alcohol, and forms a soap with the alkalies. Its s. g. is .920. EFFECTS ON THE ECONOMY IN DISEASE. Dr. Charles Calderini found, that, in the dose of from four to eight drops, it acted as a cathartic on the adult, without occasioning 1 Scattergood, in Philad. Journ. of Pharmacy, iv. 124, Philad. J833. See, also, Journal de Chimie Medicale, ii. 178. EUPHORBIA lathyris. 201 colic or tenesmus. In half the quantity, it proved cathartic to children. He gave it in sugared water, or in the form of an emul- sion ; and was of opinion that it might be advantageously substi- tuted for castor oil, especially for children. After him, it was employed by M. Crimaud, and subsequently by M. Bally,1 who carried the dose as far as ten drops. Louis Frank2 has suggested its employment in cases of taenia, hysteralgia, ascites, &c. It would appear from the remarks of Mr. Scattergood, that the oil, obtained from the beans grown in this country, does not possess the mild qualities ascribed to the European article. Six, eight, ten, and twelve drops were given to several individuals as a cathartic; and, although administered in conjunction with aromatic oils, and in one or two cases with an alkali in the form of soap, it invariably produced nausea, and even vomiting. Mr. Scattergood adds, that he has been informed by the manufacturer, Mr. Thomas Bellangee, of Crosswicks, New Jersey, that when administered in small quan- tities, and repeated at intervals of half an hour or an hour, it ope- rates on the bowels freely as a cathartic, without producing much nausea. Pichonnier3 has proposed the following formula for a cathartic mixture. Mistura Olei Euphorbia. Mixture of the Oil of Euphorbia. St. Olei euphorb. lathyr. gtt. viij. Pulv. gum. arab. £j. Sacchar. 51J. Aquae distillat. ^iij. M. 1 Journal Universel des Sciences Medicales, xii. 254. 2 Journal de Pharmacie, xi. 273; and Merat & De Lens, Diet, de Mat. Med. iii. 183. Paris, 1831. 3 Journal de Chimie Medicale. Paris, 1827. 26 202 NEW REMEDIES. FERRI PRiEPARATA. Synonymes. Preparations of Iron. French.—Les Preparations de Fer. German.—Eisenpraparate. I. FERRUM ARSENIATUM. Synonymes. Arsenias Ferri; Ferrum Arsenicicum Oxydulatum. French.—Arseniate de Fer. German.—Arsensaures Eisenoxydul, Arseniksaures Eisenoxydul. This preparation has been recommended by Mr. Carmichael,1 who often applied it externally in cases of cancerous ulcers. Na- turally, it presents itself in small, clear, bluish green crystals, of a regular octae'dral shape, and is called scorodite. Artificially, it is formed by double decomposition. METHOD OF PREPARING. Glaser gives the following formula for its preparation. Eight ounces of semivitrified white arsenic, sprinkled with a little spirit of wine and reduced to fine powder, are mixed with as much puri- fied saltpetre. The mixture is placed in an uncovered Hessian crucible, which should only be half filled with it, and then be placed in a wind furnace. At first, a slight degree of heat is applied, under which the mass soon melts, giving off copious red fumes, the inha- lation of which should be carefully avoided. The process had better, therefore, be carried on in the open air, or in a laboratory that has a chimney with a good draft. When the mass no longer gives off red fumes, and flows tranquilly, the crucible must be carefully removed from the fire, the contents be suffered to cool somewhat, and boiling distilled water be poured upon them : under active boiling they will dissolve altogether. Hot water, sufficient to fill the crucible, is now added, and the whole is allowed to remain at rest for twenty-four hours; at the expiration of which time a considerable quantity of beautiful crystals of acid arseniate of potassa is found on the sides of the crucible. The fluid, holding the salt in solution, is now filtered into a clean porcelain or glass 1 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. FERRI PR^PARATA. 203 vessel; the crystals are collected, dried carefully in the shade, and put away amongst the poisons as the Arsenias potassa acidus. The fluid poured from the crystals and filtered is now diluted with distilled water, and a solution of pure sulphate of iron added thereto so long as any precipitate is thrown down. The bluish green precipitate, insoluble in water, is the ferrurn arseniatum, which must be collected on a filter, washed and dried in the shade. The process must be conducted with the greatest care, and the vessels used be cautiously cleansed or broken, for fear that mischief may arise. In these chemical operations, the acid of the saltpetre is decomposed by being heated with the arsenious acid or white arsenic, a part of its oxygen is taken by the latter, and arsenic acid is thereby formed, which unites with the potassa of the saltpetre and forms acid arseniate of potassa ; the nitric acid being converted into nitrous acid is given off in the form of red fumes: by admix- ture of a solution of sulphate of iron with the solution of the acid arseniate of potassa, a double decomposition ensues, the result of which is the formation of sulphate of potassa and arseniate of iron, which last, being insoluble, falls to the bottom of the vessel. EFFECTS ON THE ECONOMY. According to Carmichael, this preparation acts more powerfully on the vitality of cancerous formations than any other agent, and the dead slough caused by it is much deeper than that caused by the application—which was at one time so much celebrated—called "Plunket's caustic." He allows, however, that the greatest caution should be observed in its use. Of late, he has employed a compound of the arseniate of iron with phosphate of iron ; half a dram of the former to two drams of the latter. This mixture must be applied very thin by means of a camel's hair pencil, and not over the whole surface of the ulcer when it is extensive. MODE OF ADMINISTERING. The compound just mentioned may be applied in the form of ointment, prepared in the following manner:— Unguentum Ferri Arseniatis Compositum. Compound Ointment of Arseniate of Iron. Si. Ferri arseniat. 3ss. ----phosphat. 3ij. Ung. cetacei. £vi. M. 204 NEW REMEDIES. This ointment must be spread on lint and applied to the ulcer. Werneck gives it the preference over all the usual arsenical prepa- rations. The arseniate of iron has likewise been administered in- ternally in cancerous affections. The following formula may be used. Pilida Ferri Arseniati Composita. Compound Pills of Arseniate of Iron. St. Ferri arseniat. gr. iij. Extract, gentian. 3j. Pulv. glycyrrhiz. gij. Syrup, cujusvis q. s. ut fiat Massa, in pilulas xlviii dividenda. Dose.—One, three times a day. II. FERRUM BROMATUM. Synonymes.—Bromated, or Bromide of, Iron;—in solution, Hydrobromate of Iron, Ferri Hydrobromas. French.—Bromure de Fer. German.—Bromeisen. METHOD OF PREPARING. This preparation is made by heating equal parts of bromine and iron filings under water. As soon as the fluid becomes of a greenish color it is filtered, and evaporated to dryness: the reddish residue— again dissolved in water and evaporated—is the bromide of iron. It has a brick-red colour ; dissolves readily in water, is deliquescent in the air, and has a very styptic taste.1 EFFECTS ON THE ECONOMY AND MODE OF ADMINISTERING. Magendie has prescribed it successfully in cases, in which the preparations of bromine have been indicated. (See Brominum, p. 88.) He recommends the following formula. i Magendie, Formulaire pour la preparation, &c, de plusieurs nouveaux medicamens, derniere edit. FERRI PR^EPARATA. 205 Pilula Ferri Bromati. Pills of Bromide of Iron. St. Ferri bromat. pulv. gr. xij. Confcct. rosar. gr. xviij. Gum. arab. gr. xij. Fiat massa in pilulas xx dividenda. Dose.—Two, morning and evening. Magendie. St, Ferri bromat. ^j. Extract, glycyrrhiz. q. s. ut fiat massa in pilulas lx dividenda. Dose.—One or two, morning and evening, in cases of scrofula and hypertrophy—of the uterus especially. Werneck. III. FERRUM CARBONATUM PR^CIPITATUM. Synonymes.—Ferri Carbonas Praecipitatus, F. Subcarbonas, Ferrum Car- bonicum Oxydulatum, Oxydum Ferri Fuscum, Deuto-Carbonas Ferri Fuscus, Crocus Martis Aperiens, Ferri Sesquioxydum, Subcarbonate of Iron, Sesquioxide of Iron, Peroxide of Iron. French.—Souscarbonate de Fer, Safran de Mars Aperitif. German.—Kohlensaure Eisenoxydul. This preparation, which is officinal in the British, American, and other pharmacopoeias, is formed by adding a solution of car- bonate of soda to a solution of sulphate of iron: the precipitate is the carbonate, or subcarbonate, or—as it is now called in the London Pharmacopoeia—the sesquioxide of iron, which must be washed with water, and dried. EFFECTS ON THE ECONOMY. The precipitated carbonate of iron possesses the properties of the chalybeates in general, and has been highly recommended as a tonic, wherever such remedies are indicated. We introduce it here, mainly on account of the favour which it has received, of late years, as a remedy for neuralgia. Thirty years ago, its use was strongly advised in cancer and carcinomatous ulcerations of the uterus, by Mr. Carmichael ;* and, subsequently, by Rust, Voelker, 1 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Cancer, 2d edit. Dublin, 1809. 206 NEW REMEDIES. and Kopp; as well as in a case of lupus of the ala nasi, by Key ;* but, in similar cases, it proved unsuccessful in the hands of Clarke, El. Von Siebold, Meissner, Richter, and others.2 In chronic ner- vous diseases, of a spasmodic nature, and especially in tic doulou- reux of the face, it was first highly extolled by Mr. Benjamin Hutchinson, about twenty years ago,3 who published several cases of cure effected by its agency. Soon afterwards, cases, equally fortunate in their termination, were published by various observers, by Drs. A. T. Thomson,4 Stewart Crawford,5 R. Macleod,6 Mr. J. E. Beale,7 and many others, and its efficacy is now almost univer- sally admitted. Dr. Rowland8 has often witnessed the most happy results from its exhibition, even after various powerful medicines had been tried in vain. Dr. EUiotson9 published several cases, in which the remedy, in large doses, had been efficacious; and he remarks, that true chronic neuralgia, not arising from cold, and coming on in a vio- lent, stabbing, plunging form, aggravated by the least shake of the patient, and by touching the surface, is best treated by the sub- carbonate of iron. He observes, however, in a recent publication,10 that he does not recollect that he ever cured the disease, but in almost every case improved it, and caused it to disappear for a time. In one of the severest cases of neuralgia, under the form of hemicrania, which we ever witnessed, and which had rendered the patient's life miserable for years, the subcarbonate of iron, in large doses, proved, in our hands, entirely successful. The patient had been bled repeatedly; and when we saw her, she was under the most favourable circumstances for the exhibition of the remedy, with the surface pale and cool; the pulse small; complaining much of debility, and yet suffering under the most intense head- 1 Lancet, xiv. 92. 2 Osann, in Encyclopad. Worterb. der medicinisch. Wissenschaft. x. 424. Berlin, 1834. 3 Cases of Tic Douloureux successfully treated. Lond. 1820. * Medical and Physical Journal, Feb. 1823. 5 Ibid. 6 Ibid. June, 1823. 7 Ibid. Sept. 1823. 8 Treatise on Neuralgia, by Richard Rowland, M. D., p. 84. Lond. 1838; and the reprint in the editor's American Medical Library. 9 Medico-Chirurgical Transactions, xv. 161. 10 Principles and Practice of Medicine, &c. by John EUiotson, M. D.; with Notes, &c. by Nathaniel Rogers, M. D. p. 507. Lond. 1839. FERRI PRjEPARATA. 207 ach, which the least light and noise rendered almost intolerable; yet, after she had persevered in the use of the remedy for a month, in large doses, the symptoms gradually disappeared, and she has since remained entirely well. It need scarcely be said, that where plethora exists, or febrile irritation supervenes, it must be re- moved ; the subcarbonate rarely, however, disagrees with the sto- mach, and where it does, the inconveniences are removed by the addition of an aromatic, or the administration of a cathartic. The subcarbonate of iron, in large doses, has, likewise, been found a valuable agent in a kindred condition of the nervous sys- tem—chorea. Dr. EUiotson1 affirms, that he has had—he should suppose—forty cases, in succession, all cured by it; but perseve- rance in its use is demanded, the affection generally disappearing when the remedy has been given about six weeks or two months; but in some obstinate cases, it has been necessary to continue it for twelve weeks. Like other tonics, it has been prescribed in intermittents, and not long ago, M. Gimon,2 physician at Thouars, published two cases, elucidative of the effects of large doses in long protracted intermittents, complicated with ascites and enlargement of the spleen. One of these occurred in a boy nine years old, and the other in a young man of twenty-one. Both had taken the sulphate of quinine in large doses, but ineffectually. To the former, he pre- scribed twelve grains of the subcarbonate in the twenty-four hours, augmenting the dose by six grains daily. The treatment was com- menced in the latter end of July, 1835, and the quantity taken in the day was pushed progressively to one ounce. In six months, the traces of ascites and splenocele had disappeared, and the cure was complete. The medicine was discontinued by gradually dimi- nishing the dose. In the second case, the same dose was pre- scribed, in the first instance, and it was ultimately carried to six drams, with complete success. More recently, still, Dr. Steyman3 has recommended the carbo- nate of iron for the treatment of hooping-cough, in the dose of half a grain at the least, to be taken every three hours with sugar, and increased to as many grains as, and more than, the number of years of the child's age. It should not, he advises, be administered 1 Op. citat. p. 515. 2 Journal des Connoissances Medico-Chirurgicales, Mai, 1837. 3 Medicin. Correspondenz-Blatt, and Gazette Medicale de Paris, June 20 1838. 208 NEW REMEDIES. in the first stage of the disease; and, in all cases, should be pre- ceded by an emetic. The great efficacy of this preparation—as of every tonic—in diseases that are paroxysmal, appears to consist in the new impres- sion which it makes upon the nerves of the stomach, and, through them, upon those of the whole system; but to effect the revulsion to the requisite extent, it appears to be necessary—as in the cases of the artemisia and the indigo in epilepsy—to keep up the effect of the remedy by gradually increasing the dose. MODE OF ADMINISTERING. The dose of the subcarbonate of iron, in cases of neuralgia and chorea, should be large. Mr. Hutchinson prescribed it in the quantity of 3ss to 3ij twice a day; but where it fails to remove the complaint in those doses, Dr. EUiotson recommends, that it should be increased gradually to one or two ounces. We have never found it necessary to carry it so high. The best vehicle is molasses. The following formulas have been recommended.1 Pulvis Ferri Sesquioxydi—(P. Ferri Carbonati Pracipitati.) Powder of Sesquioxide of Iron. St. Ferri sesquioxydi, gr. x. Pulv. cinnam. comp. gr. v. M. fiat pulvis mane et meridie sumendus. Boli Ferri Sesquioxydi. Boluses of Sesquioxide of Iron. St. Ferri sesquioxydi, gr. x. Pulv. Valerianae, gss. Syrup, zingib. q. s. Fiat bolus. Pilula Ferri Sesquioxydi. Pills of Sesquioxide of Iron. S<. Ferri sesquioxydi, Extract, anthemid. aa. gss. Misce et divide in pilulas xij, quarum sumat binas ter quotidie. £. Ferri sesquioxydi, £j. Pilul. aloes cum myrrha, gss. Misce et divide in pilulas xviij: duse bis terve indies sumendae. 1 Brande, Dictionary of the Materia Medica, p. 248. Lond. 1839. FERRI PR^EPARATA. 209 Electuarium Ferri Sesquioxydi. Electuary of Sesquioxide of Iron. &. Ferri sesquioxyd. Confect. aurant. aa. §j. Syrupi zingib. q. s. ut fiat electuarium cujus sumatur cochleare minimum bis vel tei die. IV. FERRUM CARBURETUM. Synonymes.—Ferri Carburetum, F. Carbonatum, F. Supercarburetum; Graphites, Plumbago, Carbo mineralis. Black Lead, Carburet of Iron. French.—Carbure de Fer, Graphite, Crayon noir, Plombagine. German.—Kohlenstoffeisen, Graphit, Reissblei. This well known substance was formerly considered to be slightly astringent and desiccative. By Weinhold,1 it has been ad- vised strongly in certain cutaneous affections, but although it has been received into various pharmacopoeias of continental Europe, as the Antwerp, Bavarian, Brunswick, Spanish, Parisian, Finnish, Prussian, Saxon, and Swedish, it has never been recognised as a therapeutical agent in this country or in Great Britain. MODE OF PREPARING. As crude graphite is frequently very impure from the attached matrix, the Prussian Pharmacopoeia has a formula for its purifica- tion, the product of which bears the name graphites depuratus. With this view, the graphite must be very finely pulverised ; a pound of it is boiled in a proper quantity of common water, for an hour, the water is then decanted, and two ounces of nitric acid and of muriatic acid, and eight ounces of common water are poured upon the graphite. This mixture is digested for twenty-four hours, frequently shaking it; the acid fluid is then poured off, and, after the residuum has been washed by an appropriate quantity of com- mon water, it is dried. EFFECTS ON THE ECONOMY. The internal use of graphite produces no perceptible change on the organic functions, except that according to Weinhold, under 1 Der Graphit als ein neu entdecktes Mittel gegen Flechten. Leipz. 1809. 27 210 NEW REMEDIES. its protracted use, the urinary secretion is augmented, and a dispo- sition to micturition excited. He found, however, that in herpetic and other cutaneous affections, it occasioned a very favourable modification in the eruption, and wholly removed it. In conse- quence of the results of his observations, he published a monograph in which he recommended the graphite to physicians in those affec- tions. He employed it as well internally as externally. The urine, he asserts, after its administration, commonly began to make a de- posite, and this continued until some change in the cutaneous affection announced its approaching cure. In cases of complication of herpes with other affections, Wein- hold combined it with other remedies ; in syphilitic eruptions adding corrosive sublimate, &c. The efficacy of the graphite in herpetic and other cutaneous affections, has also been attested by many other respectable physi- cians, as Horn, Heim, Ruggieri, Brera, Bernstein, Hildenbrand, Richter, Hufeland, Marc,1 &c. This gave occasion to its admis- sion into the Prussian Pharmacopoeia, yet it has not the confidence of physicians, even in those countries into the pharmacopoeias of which it has been received, and is consequently but little used. Its use in chronic cutaneous diseases is said to have been sug- gested by the circumstance, that, in Venice, the makers of crayons are speedily cured of any such affections under which they may labour.2 METHOD OF ADMINISTERING. Internally, graphite is given in doses of from five to fifteen grains, from two to four times daily; and the dose may be augmented, according to circumstances, to a dram in the day. It is given in powder, or in the pilular form. Externally, it is applied in the form of ointment or plaster—from 3ij to 3yj of the graphite to an ounce of the constituent. 1 Riecke, Die neuern Arzneimittel, u. s. w. Stuttgart, 1837, S. 214; see, also, Weinhold, in Hufeland's Journal, B. xxxiv. St. 1. S. 118; Heim, in Horn's Archiv. 1810, xii. 326, and Ibid. 1811, B. 1. S. 91; Huber, in Med. Chir. Zeitung, 1811, No. 68, S. 282 ; Hufeland, Journ. der prakt. Heilkunde, B. xxxviii. St. 6; Bernstein, Ibid. B. xii. St. 5 ; Mayer, Ibid; B. Ix. St. 2, and Osann, in Encyclop. Worterb. der Med. Wissensch. x. 434. Berlin, 1834. 2 Merat & De Lens, in Diet, de Mat. Med. Art. Carbone. FERRI PR^PARATA. 211 Pulvis Ferri Carbureti. Powder of Carburet of Iron. St. Ferri carburet, pur. Sacch. alb. aa. gss. M. Divide in partes aiqual. vi. Dose.—One every two hours—in lichen leproides. HlLDENBRAND. Electuarium Ferri Carbureti. Electuary of Carburet of Iron. St. Ferri carburet, pur. gss. Mellis despumat. ^ij. M. Fiat electuarium. Dose.—A coffee-spoonful morning and evening. Weinhold. Pilula Ferri Carbureti. Pills of Carburet of Iron. S>. Ferri carburet, pur. Extract, dulcamar. aa. &j. M. fiant pilulse, pond. gr. ij. Dose.—Six, three times a day. Maerker. St. Ferri carburet. 3ij. Flor. zinci. £ss. Axung. porcin. 3j. M. Mayer. Unguentum Ferri Carbureti. Ointment of Carburet of Iron. &. Ferri carburet, pur. » Sulphur, depurat. aa. gij. Axung. porcin. q. s. ut fiat unguentum. Brera. Emplastrum Ferri Carbureti. Plaster of Carburet of Iron. &. Ferri carburet, depur. Jij. Emplast. sapon. =>iv. Misce intime. Weinhold. 212 NEW REMEDIES. V. FERRUM CYANURETUM. Synonymes.—Ferri Cyanuretum.F. Cyanogenatum, F. Oxydulatum Hydro- cyanicum, F. Borussias, Ferro Sesquicyanidum, F. Percyanidum, Ferro- cyanas Oxydi Ferri, Ferri Ferrocyanas, Ferrum Zooticum, F. Borussicunij Coeruleum Borussicum, C. Beroliniense, Prussiate of Iron, Cyanuret of Iron ; Prussian Blue. French.—Trito-hydro-ferro-cyanate de Fer; Deutoxicyanure de Fer Hy- drate; Tritohydrocyanate Ferrure de Fer, Prussiate de Potasse et de Fer, Bleu de Prusse. German.—Cyaneisen, Blaustoffeisen, Blausaures Eisenoxydul, Eisenblau- saures Eisenoxyd, Eisencyaniircyanid, Berliner Blau, Pariser Blau. In commerce, this preparation with us bears the name " Prus- sian blue," but in Germany it is called "Pariser Blau." It is not in a state of purity, and, consequently, that which the apothecary prepares is best adapted for internal use. MODE OF PREPARING. The form given by Buchner is as good as any. The ferrocyanate of potassa, as commonly met with in commerce, is dissolved in warm distilled water, and to the clear filtered solution is gradually added, in a glass vessel, a solution of chemically pure sulphate of iron so long as a precipitate is thrown down. After the precipitate has fallen to the bottom of the vessel, and the supernatant fluid, which contains sulphate of potassa, has been poured off, the precipitate is first digested with dilute sulphuric or muriatic acid, in order to dis- solve the excess of oxide of iron ; the beautiful dark blue precipitate is then collected on a filter, carefully washed with boiling water, and dried. The cyanuret of iron is of a beautifuLdeep blue colour, and de- void of odour and taste. It is decomposed by heat, and is insoluble in water, alcohol, ether, oils and dilute acids. Potassa and soda decompose it. According to Zollickoffer it adheres firmly to the tongue, which Riecke thinks, though erroneously, is owing to its containing argil. EFFECTS ON THE ECONOMY. Of the effects of the cyanuret of iron on the human economy in health we have no evidence. Coullon gave it to various animals, but observed no action from it. Tt has been given, and not without FERRI PR^SPARATA. 213 success, in several diseases; and Dr. L. W. Sachs, who has not unfrequently administered it, considers it one of the most important chalybeates with which we are acquainted. He thinks it probable, that the hydrocyanic acid has not much agency; yet it certainly seems to differ from all the other preparations of iron. It has been especially recommended in epilepsy by Kirckhoff1 of Ghent. In very obstinate cases, not dependent upon organic mis- chief, he succeeded entirely with it; with the adult he commenced with half a grain daily, and raised the dose gradually to three four, and even six grains and upwards. When the patient was plethoric, he premised bloodletting, or applied leeches, from time to time, to the temples. Hildenbrand and Gergeres confirm its efficacy in epilepsy. In intermittent fever Zollickoffer2 found the cyanuret of iron so efficacious, that he even gave it the preference over the cinchona; and his experience has been confirmed by that of Eberle,3 Hosack4 and others. Wutzer, in Germany, also exhibited it successfully; and Stosch gave it advantageously, in combination with cinchona and rhubarb, in a case of obstinate intermittent. Sachs likewise tried it frequently, but as often without as with success. When it has proved efficacious in intermittents the dose has been by no means large. Some have given six or eight grains every four hours during the apyrexia, and even as much as a scruple has been ad- ministered. Sachs found it several times efficacious when four doses of two grains each were taken. Riecke5 affirms that his father obtained essential service from it in the leucophlegmatic con- ditions resulting from intermittent fever. Zollickoffer extols the cyanuret also in remittent fever, and there may doubtless be periods when it may be administered with benefit, but it is not often used. He recommends it also in dysentery,6 when the inflammatory condition has passed away, either spontaneously or under the efforts of art; and Sachs remarks, that in those atonic conditions of the intestinal canal, which supervene on dysentery, it may doubtless be of great service. Gergeres administered it suc- cessfully in chronic diarrhoea. L. W. Sachs enters into a long 1 Journal de Chimie Medicale, iii. 285. 2 American Medical Recorder, v. 540. 3 Materia Medica, 2d edit. i. 233. 4 New York Medical and Physical Journal, 1823. 5 Op. cit. S. 217. 6 Chapman's Philadelphia Journal, Aug. 1823. 214 NEW REMEDIES. theoretical disquisition on the precise action of the remedy, in which there is doubtless much that is speculative. He used it, he says, with success, in many cases which it would be difficult to classify under any formal nosology; their common bond, however, was, that they were dependent upon "nervous disorders, especially of the plastic functions of the abdominal organs, the mischief appearing first of all to be gastric." In such affections, he found a combina- tion of the cyanuret of iron with rhubarb especially serviceable. He gave it in not less than two grains for a dose, which he gradually augmented to six grains three times a day. Dr. Moll saw decidedly good effects from its use in a case of immoderate menstruation from atony of the uterus with general elevation of the nervous excitability, after he had employed the remedies commonly recommended un- successfully. He found it also extremely beneficial to children of a strumous habit, and great torpor. Stosch found it serviceable in a case of scrofula, in which hasma- tosis was imperfectly accomplished, and Dr. Bridges1 found great advantage from it in a case of severe and protracted facial neu- ralgia. Externally, the cyanuret of iron has been used in the form of ointment, in cases of ill conditioned, torpid and foul ulcers, and even of noli me tangere. Stosch applied it in a case of fungous ulcer with marked advantage; forming it into a paste with water and applying it in that form. MODE OF ADMINISTERING. Pulvis Ferri Cyanureti. Powder of Cyanide of Iron. St. Ferri cyanuret. gr. iij ad xxxvj. Sacchar. alb. gij. M. et divide in pulveres vj. Dose.—A powder two or three times a day, in epilepsy. KlRCKHOFF, &. Ferri cyanuret. gr. j, iv, vj ad xij. Sacch. alb. 3J. Fiat pulvis, in partes xij sequales dividendus. Dose.—A powder every two hours, in epilepsy. HrLDENBRAND. 1 Wood & Bache's Dispensatory, Art. Ferri Ferrocyanas. FERRI PR.EPARATA. 215 St. Ferri cyanuret. Pulv. guaiac. aa. 3j. Misce et divide in chartulas xij. Dose.—One three times a day.—Employed successfully in inter- mittents.1 Pilula Ferri Cyanureti. Pills of Cyanide of Iron. St. Gum. ammon. Rad. rhei, Ext. taraxac. aa. 3j. Ferri cyanuret. gr. xviij ad xxxvj. M. et fiat massa in pilulas lx dividenda. Dose.—Four to six, twice a day, in disorder of the ganglionic system. Radius, according to L. W. Sachs. Unguentum Ferri Cyanureti. Ointment of Cyanide of Iron. St- Ferri cyanuret. £j. Unguent, cetacei, 3j. M. et fiat unguentum. Applied to foul ulcers. VI. FERRUM IODATUM. Synonymes.—Ferri lodidum, Ferri loduretum, lodated Iron, Iodide of Iron, Ioduret of Iron, Protoioduret or Protoiodide of Iron. French—Iodure de Fer, Proteiodure de Fer. German.—Iodeisen. AND FERRUM HYDRIODATUM. Synonymes.—Ferri Hydriodas, Ferrum Hydroiodicum Oxydulatum, Hydrio- dated Iron, Hydriodate of Iron, Hydriodate of Protoxide of Iron. French.—Hydriodate de Fer. German.—Hydriodsaures Eisenoxydul. Although attention had been directed, several years ago, to this preparation, it was not much used, until Prof. A. T. Thomson,2 of 1 Ellis's Formulary, 5th edit. p. 161. Philad. 1838. 2 Some observations on the preparation and medicinal employment of the Ioduret and Hydriodate of Iron, 8vo. pp. 64. Lond. 1834. 216 NEW REMEDIES. the London University, recommended it strongly in a special monograph a few years since. It has been lately received into the London Pharmacopoeia. MODE OF PREPARING. The following method is recommended by Dr. Thomson. One part of iron wire should be rubbed in a porcelain or wedgwood mortar, with about three or four parts of iodine, gradually adding distilled water, until fifteen parts of the fluid have been used : the whole is then to be introduced into a Florence flask, with an addi- tional portion of wire and of distilled water. This excess of iron is a matter of indifference in the preparation of the hydriodate, and in that of the iodide it is necessary for preserving the combination from decomposition during the evaporation of the solution. These materials are next to be boiled together, until the fluid acquires a pale greenish colour, when it must be filtered. This solution con- tains a hydriodate of the protoxide of iron ; and, if the exact quan- tity of the iodine be previously ascertained, so as to enable us to procure the solution of a definite strength, it may be kept in this state for medicinal use. In general, however, the solution is evapo- rated to dryness, and for this purpose it may be poured into a clean flask, containing a piece of iron wire sufficiently long to reach from the bottom to the surface of the fluid, and the boiling should be continued until the bulk of the solution be reduced to one third. It must then be filtered, after which the evaporation should be con- tinued to dryness. It is necessary to break the flask as soon as the mass is cold, in order to obtain the solid iodide, which should be immediately transferred to a dry bottle, accurately fitted with a ground stopper. The bottle should not hold more than two ounces of the preparation ; for when it is large and not full, the iodide deliquesces nearly as rapidly as when it is exposed to the free action of the atmosphere. When the flask is broken, and the iodide bot- tled before the mass is cold, deliquescence also takes place, a peroxide of the metal is formed, and iodine is evolved. The plan proposed by Mr. Durand,1 of Philadelphia, after that by MM. Baup and Caillot,2 for preparing the solution of the proto- iodide of iron (hydriodate of protoxide of iron) is the following :— Take of iodine 3x, iron filings, perfectly pure and unoxidised, 1 Philad. Journ. of Pharmacy, iv. 287. Philad. 1833. 2 Ibid, i. 201. FERRI PR^PARATA. 217 3v, distilled water gxiiss. Put the iodine into a porcelain capsule, with one half the quantity of water, add the iron filings by small portions, stirring the mixture with a glass rod. The combination soon takes place ; heat is evolved with the disengagement of a small quantity of vapour of iodine, and the mixture acquires an orange colour, which gradually deepens to a dark red. When the whole of the iron has been added, the capsule is put in a sand bath or over the flame of a spirit lamp and heated slowly; continuing to stir the liquid. An iodureted hydriodate of iron is first produced, which, under the action of heat, soon passes to the state of a simple hydriodate. This point is indicated by the entire discoloration of the solution. In this state it is filtered ; and the dregs and filter are carefully washed with the remaining half of the distilled water, previously heated to the boiling point. In this manner, a solution forming twelve and a half fluid ounces is afforded, one ounce of which represents one dram of iodide of iron. The solution, which is at first colourless, acquires a deep red colour by standing, and precipitates some oxide of iron ; by which* it is reduced to the state of an iodureted hydriodate of iron ; but it may be easily restored to its former state by heating it again with a small quantity of iron filings, until the liquid becomes colourless. The iodide of iron is obtained by evaporating to dryness the fil- tered solution, taking care, towards the end, to stir incessantly with an iron spatula, and to detach the salt from the bottom of the cap- sule as it forms. The heat must be managed most carefully, diminishing it gradually, and removing the capsule quickly from the fire as soon as the odour of iodine is evolved. The solution of this salt, when the iodide is well prepared, is of a light orange colour, and deeper in proportion to the decomposition which some parts may have undergone towards the end of the operation. The iodide requires to be well secured from the influence of the atmosphere, both on account of its deliquescent property, the rapid oxidation which the metal undergoes when deliquescence occurs, and the consequent decomposition which takes place. It is im- portant to prevent this, as the peroxide of iron is inert as a medi- cinal agent; whilst the free iodine extricated during its operation, according to Dr. Thomson, alters altogether the virtues of the medicine. This partial decomposition of the iodide is rendered immediately apparent on dissolving it in twenty times its weight of distilled water, and filtering: instead of a permanent, clear, very pale greenish yellow, we obtain an ochre-coloured, completely in- soluble precipitate. Much of the iodide, usually prepared, is of 28 213 NEW REMEDIES. this description, and to this may, doubtless, be referred some of the disappointment and discrepancy amongst practitioners as to the operation of the medicine in cases apparently similar. Even when the iodide has been carefully prepared, it often contains a little free iodine; but, according to Thomson, it is chiefly owing to the carelessness of assistants and apprentices in compounding prescrip- tions, by frequently exposing the iodide to the air, that its proper- ties, and, consequently, its medicinal powers, are impaired : hence, it is preferable to keep it in solution, or in the form of hydriodate, which it becomes, whenever water is added to it. If the solution be prepared with a definite quantity of iodine, as described, it will keep without changing its characters; but as it is usually made, by dissolving the iodide in distilled water, it requires to be rendered neutral by the following means :—Introduce into a flask the solution of any given strength, and place in it two or three doubles of clean and soft iron wire, sufficiently long to ex- tend to the surface of the fluid ; boil for a few minutes, and then leave it at rest, until the solution becomes clear, after which it may be either decanted off from the precipitate which forms, or filtered : no farther change takes place in a solution thus treated, provided it be kept in a blackened or a green bottle, however long it may be preserved. In this process, the wire affords iron to saturate any free iodine present in the solution, or that may have been extri- cated by the formation of the peroxide of iron in the iodide; and a perfectly neutral solution being thus obtained, by the immediate conversion of the newly formed iodide into the hydriodate of the protoxide, no subsequent change takes place so long as the solution is kept secluded from the light. The best proportions, according to Dr. Thomson, for forming the medicinal solution, are three grains of the dry solid iodide to each fluidram of distilled water. If the water be not either distilled or filtered rain water, perfectly free from foreign ingredients, and particularly if it contain any earthy or saline carbonates, decomposition instantly takes place, iodine is extricated, and a carbonate of iron, which rapidly passes into the state of a peroxide of that metal, is precipitated. When iodide of iron is carefully prepared, it is of an iron gray colour, foliated texture, brittle, and exhibits a crystalline arrange- ment similar to metallic antimony, except that it is darker. In the dry state, it is inodorous; but, when moist, it smells somewhat of iodine : the taste, when dry, is simply styptic ; when moist, some- what acrid, before it impresses the gustatory organs. At 350° of Fahrenheit it fuses ; and, at a higher temperature, is decom- FERRI PRjEPARATA. 219 posed,—the iodine being volatilised, and the iron remaining in the state of oxide. It dissolves in all proportions in water,—the changes supervening, which have been already indicated. It is decomposed by chlorine, the mineral acids, oxide of arsenic, me- conic acid—consequently by opium and laudanum—gallic acid, and tannin, the pure and carbonated alkalies, different metallic salts, and by the infusions of digitalis, belladonna, hyoscyamus, tobacco, amylaceous substances, &c.: such substances ought not, therefore, to be given in combination with it. EFFECTS ON THE ECONOMY IN HEALTH. From experiments made on his own person, Dr. Thomson states the following to be the physiological effects of the hydriodate of iron. When taken in doses of from three to five grains, it makes no sensible impression on the stomach, although it sharpens the appe- tite, and improves the digestive function: it seems to stimulate moderately the digestive canal through its entire length; for it opens the bowels; and, whilst it produces the black colour of the alvine discharges characteristic of all the preparations of iron, it corrects their foetor. When it does not affect the bowels, it aug- ments the action of the kidneys, increasing the flow of urine ; and if the solution be taken two or three times a day, for several days successively, the presence of both the iodine and the iron can be readily detected in the urine. The temperature of the skin is mo- derately elevated, and the insensible perspiration increased. On one occasion, having taken ten grains for a dose, it almost imme- diately caused an uneasy sensation at the epigastrium, accompanied with nausea that continued for several hours, and a slight degree of headach. These symptoms were relieved by a copious evacua- tion, which was perfectly black. Two hours after taking the me- dicine, a large quantity of urine was discharged ; which, on being tested, displayed the presence of both the iodine and the iron. The experiments on animals, made by Dr. Cogswell,1 induced him to infer:— 1. That the iodide of iron acts as a local stimulant, possessing the power of effecting peculiar dhNorganisation. 2. That its action is more particularly directed to the tract of the alimentary canal. 1 Essay on Iodine, p. 132. Edinb. 1837. 220 NEW REMEDIES. When added to blood out of the body, the iodide of iron pro- motes its coagulation.1 EFFECTS ON THE ECONOMY IN DISEASE. From the chemical composition of the iodide of iron, Dr. Thom- son considered it might be specially adapted for cases in which augmented activity of the capillary, or intermediate system, with a tonic effect, might be indicated, and particularly in scrofulous affec- tions, tabes mesenterica, chlorosis, incipient scirrhus, rickets, ame- norrhoea, bronchocele, atonic dyspepsia,—indeed, in all cases ac- companied by debility. In such affections, he conceives the iodide will act more efficiently than any of the other preparations of iron. In secondary syphilis, it may be combined, he suggests, with iodide of potassium; and in incipient cancer, its efficacy, is aided by the administration of arsenic at the same time. Dr. Thomson has found it serviceable in atonic gastric dyspepsia, when com- bined with bicarbonate of potassa, and taken at the moment of ad- mixture, in the dose of from three to eight grains or more.3 A great advantage it possesses is its ready solubility, owing to which it can enter the circulatory system with facility, and modify the condition of the fluids. In chronic scrofulous cases, it produces all the good effects of the preparations of iron, without any of the concomitant and subsequent symptoms that are so apt to super- vene, especially in impressible individuals. Where the case is accompanied by vascular erethism, or fulness, they must be re- duced before the iodide can be esteemed appropriate. In chlorosis, occurring in strumous habits, it has been found most serviceable. Its efficacy in cancer is elucidated by Dr. Thomson, by the de- tails of a case of scirrhous mamma, which, after protracted and fruitless treatment by other agents—as by other preparations of iron combined with conium—ultimately yielded to a combination of the hydriodate of iron and conium. Some cases are also detailed in which the hydriodate of iron was very effective in removing old syphilitic affections, especially of the skin. Prior to the publication of Thomson, Pierquin had given the 'Magendie, Lecons sur le Sang, &c; and translation in the Lancet, Jan. 26, 1839. * London Dispensatory, and Brande's Dictionary of Mat. Med. p. 252. Lond. 1839. FERRI PR^EPARATA. 221 iodide in cases of leucorrhoea and amenorrhcea, and Eager1 had re- commended it in scrofula. Ricord2 found the very best effects from its internal use in cases where tonics required to be combined with antisyphilitic remedies, especially where any scrofulous vice (lymphatisme) constituted a complication. He administered it like- wise with great success, to remove the consequences of syphilis, and found it advantageous in atonic ulcers of the legs and in spreading ulcers of the throat, which had been aggravated or had not yielded to mercury. The strength of M. Ricord's solution was half a dram of the iodide to gviij of water, given, we presume, in the twenty-four hours. M. Ricord3 also uses it in the form of injection in cases of blen- norrhoea. Wherever, indeed, tonic astringent injections are needed, the iodide, in his opinion, should occupy the first rank. Its use, he thinks, can only be contra-indicated when there is much inflam- mation or pain in passing the urine, or when cystitis exists. The strength of the injection should be three grains to the ounce of water. In consequence of its promoting the coagulation of the blood out of the body, Magendie4 prescribed it recently in the form of injec- tion (3i to ftij of water) employed several times a day in a case of severe uterine hemorrhage. The hemorrhage ceased. We have frequently given this remedy in public and private practice, and have considered it especially adapted for those cases in which there appears to be torpor in the system of nutrition, as in cases of asthenic dropsy, old visceral engorgements, and indeed of hypertrophy of any kind, accompanied by deficient action in the intermediate system of vessels. In oligaemia, where there is paucity of red globules in the blood, and the fluid is altogether too thin, it would seem to be especially indicated, from its property, mentioned above, of promoting the coagulating of the blood, and therefore, of inspissating it. Hence in all cases of scorbutic, hy- dropic and other dyscrasies, and in hemorrhages occurring in such pathological conditions of the system, we have prescribed it largely and with the very best effects. It appears to us, indeed, to be 1 Dublin Journal of Medical Science, 1834; also, Cogswell on Iodine, p. 138, Edinb. 1837. 2 J. J. L. Rattier, in La Lancette Frangaise, Fev. 4, 1837. 3 J. J. L. Rattier, Ibid. Fev. 16, 1S37; see, also, Revue Medicale, Janvier 1S38, and American Med. Intelligencer, Sep. 15, 1838, p. 195. 4 Op. cit. 222 NEW REMEDIES. the best remedy we possess wherever a sorheficient and tonic are indicated. MODE OF ADMINISTERING. The dose of the iodide of iron, administered in the cases above referred to, was generally three or four grains two or three times a day. Liquor Ferri Iodidi. Solution of Iodide of Iron. St. Ferri iodidi, gr. xxiv. Aquae destillat. gj. M. Dose.—An ordinary tea-spoonful contains about three grains. A. T. Thomson. The following formulas are recommended by Pierquin :J Vinum Ferri Iodidi. Wine of Iodide of Iron. St. Vin. Bordegalens. B5j. Ferri iodidi, gss. M. Dose.—A tea-spoonful morning and evening. Tinctura Ferri Iodidi. Tincture of Iodide of Iron. St. Ferri iodidi, 31J. Alcobolis, Aquae, aa. ^ij. M. Dose.—A tea-spoonful morning and evening. Trochisci Ferri Iodidi. Lozenges of Iodide of Iron. St. Ferri iodidi, £j. (3SS) Croci pulv. ^ss. (£ij-) Sacchar. alb. |[viij. (§iv.) M. fiant Trochisci No. 240, (120.) Dose.—Six to ten daily. 1 Journal de Chimie Medicale, p. 310, Mai, 1831. FERRI PRiEPARATA. 223 Solutio Ferri Iodidi. (French, Eau $ Hydriodate de Fer.) Solution of Iodide of Iron. St. Ferri iodidi, ^ss. Aquae, ibij. M. Added to enemata, lotions, and injections. St. Ferri iodidi, ^ss ad ^ij. Aquae destillat. B5j. M. To be added to a general bath in cases of leucorrhoea, ame- norrhoea, (fee. Pierquin. Unguentum Ferri Iodidi. Ointment of Iodide of Iron. St. Ferri iodidi, ^iss. Adipis suillae, ^j. M. ut fiat unguentum. A piece of the size of a hazelnut to be rubbed, morning and evening, on the inner part of the thigh, in cases of leucorrhoea and amenorrhoea. VII. FERRUM NITRATUM. Synonymes.—Ferri Nitras, Nitrate of Iron. LiaUOR FERRI PERSESQUINITRATIS. Synonymes.—Liquor seu Solutio Nitratis Ferri, Liquor Ferri Nitrici Oxy dati, Solution of Persesquinitrate of Iron, Solution of Nitrate of Iron. MODE OF PREPARING. This preparation, which has been introduced within the last few years into practice, may be formed in the following manner. Take of small chips or pieces of iron wire, an ounce and a half; nitric acid, three ounces by measure; water twenty-seven ounces ; muriatic acid, one dram. Put the iron into an earthenware vessel, and pour on the nitric acid, previously diluted with fifteen ounces of the water. Set the vessel aside till the whole of the acid has united with the iron, so as to form a persesquinitrate, then decant the liquid from the portion of iron, which remains undissolved- strain and filter. Add the muriatic acid with the remainder of the 224 NEW REMEDIES. water, or with as much of that liquid as will increase the whole solution to thirty ounces. When the process is finished—which takes some hours—the liquid has a red colour, so dark, that when viewed by reflected light, it seems almost black. Three ounces of nitric acid of the usual strength (1.4) generally dissolve an ounce of iron, so that when the process is completed, a portion of the metal remains undissolved. The solution then con- sists entirely of the persesquinitrate of iron ; and, if speedily de- canted, it may be preserved in that state, but if allowed to stand for a few hours longer on the iron, it will undergo a further change, becoming gradually converted into pernitrate and pro- tonitrate of iron. The first of these is insoluble, and renders the liquid turbid ; and the latter, which remains dissolved, has not the medical properties that render the persesquinitrate valuable. When the solution contains nothing but nitric acid and peroxide of iron, it slowly undergoes decomposition on standing, so that, at the end of a few weeks, the whole liquid begins to become turbid. The addition of some muriatic acid prevents this decomposition, and the quantity sufficient for this purpose is too small to affect the medi- cinal powers of the persesquinitrate. The solution, when properly prepared, is of a beautiful dark red colour, when viewed with transmitted light. Its taste is very astringent, and not at all caustic.1 EFFECTS ON THE ECONOMY IN HEALTH. This preparation greatly resembles the solution of the muriate of iron in its medicinal properties. Mr. Kerr considers, that to an astringent power, it unites the property of diminishing the irrita- bility and tenderness of the mucous membranes with which it comes in contact. Kopp administered it with the greatest success in many cases of chronic diarrhoea that had resisted every approved remedy. The fasces were blackened by it, as by the preparations of iron in general. He remarks, however, that it must be continued for some time. The dose he gave was ten drops several times a day in oatmeal gruel, and this was gradually raised to twenty and twenty- 1 Mr. Kerr, in American Journal of the Medical Sciences, for May, 1832, cited from Edinb. Med. and Surgical Journal. FERRI PRjEPARATA. 225 five drops. When the cure was accomplished, the remedy was gradually diminished, until it was left off altogether. Dr. Graves' speaks in equally high terms of the persesquinitrate in these cases; and very recently Dr. T. C. Adam of Lenawee county, Michigan, has recorded the remarkable assistance, which he has derived from its use in the treatment of several diseases, espe- cially diarrhoea, and other affections of the mucous membranes accompanied by discharges.2 In chronic diarrhoea depending mainly on an excess in the sensibility of the organic nerves which supply the digestive tube, Dr. Adam rarely orders less than fifteen drops at the commencement, and after a few days' employment of the remedy, he increases the quantity to twenty, twenty-five and thirty drops. In leucorrhoea occurring in such as are pale, exanguious, feeble and languid, the internal, conjoined with the external, use of the persesquinitrate has been found very advantageous. In these cases, Dr. Adam adds such a quantity of water as a diluent as will still leave in the vagina a gentle degree of heat or smarting. Dr. Adam recommends it also in cases of aphthous sores; and he affirms that its application has afforded relief in toothach. It is doubtless a powerful astringent, but it is questionable whether it possess any advantage over the solution of the muriate of iron. VIII. FERRUM OXYDATUM HYDRATUM. Synonymes.—Hydras Ferricus, Hydro-oxide of Iron, Hydroxide of Iron, Hydrated Oxide of Iron, Hydrated Peroxide of Iron, Hydrated Tritoxide of Iron. German.—Eisenoxydhydrat. The hydrated oxide of iron has been recently introduced into practice as an antidote to white arsenic. Dr. Bunsen,of Goettingen, had already made frequent experiments with it, which satisfied him that it was an efficacious agent, when, along with Di. Ber- thold,3 he subjected it to fresh trials. The results of their inves- tigations were published, and since then it has received due atten- tion every where. » Clinical Lectures, Amer. Med. Library Edition, p. 128. Philad. 1838. 2 American Journal of the Medical Sciences, May, 1839, p. 61. 3 Das Eisenoxydhydrat, ein Gegengift der arsenigen Saure. Gutting. 1834. 29 226 NEW REMEDIES. METHOD OF PREPARING. The best mode of preparing it, according to Dr. Bunsen, is to take a solution of pure sulphate of iron, increase its dose of oxygen by treating it with nitric acid, and precipitate the oxide by adding pure ammonia in excess, washing the precipitate. In order not to deprive the precipitate of its water, and to diminish its loose state of aggregation as little as possible, it is not filtered, but is put aside for a few days, until the precipitate is wholly deposited, after which the supernatant fluid is poured off. It is then kept in well- stopped vessels. Riecke1 has added the formula for pharmaciens, which is recom- mended by Von Specz. St. Vitrioli ferri puri crystallizati libram ; teratur in pulv. subtiliss. et detur in vas. porcellan. aut murrhinum, impositum balneo arena?, dein adde acidi nitrici concentrations; terantur ope baculi vitrei usque dum massa resolvitur in pultem; nunc, igne animato, massae pultacese calidse aliunde sensim terendo, sensim acid, nitric, concentrat. q. s. donee nullum amplius evolvatur gas nitrosum. Massa tunc leni igne evaporetur ad siccitatem et solvatur demum in aq. destill. q. s.; solutioni filtratae instilletur am- monia purai q. s. donee precipitatio cesset; stent nunc per horam unam alteramve et liquor limpidus a sedimento bruneo decantetur; massae resi- dua; fundum petenti adfunde aq. destillat. Ibiij et agitentur; nunc filtra, et prsecipitatum in filtro aq. destill. q. s. edulcora donee aqua insipida de- fluat. Praecipitatum bene edulcoratum in umbra siccatum convertat. in pulv. subtilissim. qui servetur base vitreo bene clauso.2 Lassaigne advises it to be prepared as follows:—Take iron filings; pour gradually upon them four times their weight of the 1 Die neuern Arzneimittel, S. 227. Stuttgart, 1837. 2 " Take of pure crystallised sulphate of iron a pound : rub it into a subtle powder, and place it in a porcelain or glass vessel in a sand-bath; then add half a pound of concentrated nitric acid; stir them with a glass rod until the mass is resolved into a soft paste; then—the fire being raised—pour gradually on the hotpultaceous mass concentrated nitric acid, until no more nitrous gas is evolved. Let the mass be evaporated by a gentle heat to dry- ness, and at last be dissolved in a sufficient quantity of distilled water. Into the filtered solution drop pure ammonia as long as any precipitate oc- curs ; let it now stand for an hour or two, and then pour off the limpid liquor from the brown sediment. On the residuary mass, remaining at the bottom, pour three pounds of distilled water, and shake them together: filter and wash the precipitate on the filter with distilled water, until the water is tasteless. The well-washed precipitate dried in the shade forms a subtle powder, which may be kept in a well-closed vessel." FERRI PR^PARATA. 227 nitric acid of commerce in small portions. Heat is thereby de- veloped, and deutoxide of azote, which is transformed by the atmospheric air into nitrous acid vapours. When the evolution of gas has ceased, ten or twelve parts of water are added; the mix- ture is then filtered, and ammonia added until the mixture begins to exhibit an alkaline reaction. The precipitate, thus formed, is the hydrated oxide of iron, which is collected on the filter, and washed with boiling water until it is tasteless, and ceases to exhibit any alkaline characters. The mode of preparation, recommended by Majeste, agrees with this, except that he boils one part of iron filings with four of nitric acid and four of muriatic acid. EFFECTS ON THE ECONOMY. If a solution of arsenious acid be decomposed by fresh precipi- tated oxyhydrate of iron suspended in water, traces of arsenic can no longer be detected in the filtered liquid, made acid and tested by a stream of sulphuretted hydrogen gas. To throw down one part of arsenic, in this manner, requires a quantity of the oxyhydrate, which contains at least ten or twelve parts of oxide of iron. Yet even where a smaller quantity is employed, the arsenious acid is almost wholly separated, as a stream of sulphuretted hydrogen gas affords only very slight traces of sulphuret of arsenic in the filtered and acidulated liquid. When the substances are previously heated, or the arsenious acid is exposed in small portions to the precipi- tating agent, the reaction is still slighter. If a few drops of am- monia be added to water in which the oxyhydrate of iron is sus- pended, and the mixture be digested with fiuely powdered arsenious acid, an insoluble arsenite of iron is formed ; a circumstance which would encourage the belief—even had it not been sanc- tioned by experience—that freshly prepared oxyhydrate of iron may serve as an antidote to arsenic: the union between it and arsenious acid forming—as we have seen—an insoluble compound, devoid of all poisonous influence on the economy, and only ex- citing gastric oppression, when given in large doses. Accurate microscopical investigation in experiments on ani- mals that had taken arsenious acid in the solid form mixed with the oxyhydrate, exhibited to the discoverer of the antidote, that under the influence of the animal heat and the peristaltic motion' it had become completely converted into the arsenite of iron and thus rendered innocuous. Such was the result of the observations 228 NEW REMEDIES. of Boulet,1 Orfila, Chevalier, Lassaigne, Soubeiran & Miqnel,3 Nonat, Borelli & Demaria,3 Lesueur, Boulay tils,4 Monod5, and Von Specs. On the other hand, the experiments of Brett,6 Reginald Orton,7 and Cramer, were unfavourable; but Messrs. Bunsen and Berthold remark, that the experiments of those gentlemen could not be expected to be successful, as they were made with doses of arsenic of from two to nine grains; and the stomach of the rabbit cannot retain more than from one ninth to one half the quantity of the antidote prepared according to their formula, which is neces- sary to neutralise that quantity of the poison. Messrs. Bunsen and Berthold, from the results they have ob- tained, recommend the oxyhydrate as the chief antidote in all cases of poisoning by arsenic ; and they advise emetics to be asso- ciated with it—along with the agents hitherto employed—first, when the quantity of the poison taken has been considerable, and, therefore, a very large quantity of the antidote is demanded; secondly, when, at the same time, substances containing tannin, as infusion of green tea, or sulphuretted hydrogen, developed after the eating of eggs, may be suspected in the alimentary canal,—as these substances are closely related to the antidote, aud may weaken its action ; and, thirdly, when, prior to taking the poison, the stomach has been overloaded with food, and is, therefore, capable of receiving only a small quantity of the antidote. But, whether vomiting may be excited or not, recourse must be had to the oxyhydrate as speedily as possible. Tepid mucilaginous drinks may also be given to envelope the particles of arsenic that may exist in the compartments of the stomach. If the quantity of the poison taken be unknown, the antidote may be administered in a considerable dose, and if the patient should vomit, it may be ex- hibited afterwards in smaller quantity. But, if no vomiting should arise, it is recommended that he should continue to take the oxyhydrate until the arsenite of iron formed has had time to pass into the intestinal tube; and even after this it may be persevered with in small doses for a time, as portions of arsenic may possibly remain behind unchanged. With the same view, the oxyhydrate 1 Gazette Medicale de Paris, 1834. 2 Bullet. General de Therap. Dec. 1834. 3 Br. and For. Med. Rev. April, 1836, p. 594. 4 Journal Hebdcm. des Progres des Sciences Medec. Mars 14, 1835. 6 Gazette Medicale, Aug. 22, 1835, and Annales d'Hygiene, &c. xiv. 134. 6 Lond. Med. Gaz. xv. 220. 7 Lancet, Nov. 8, 1834. FERRI PR^EPARATA. 229 may be thrown up in the way of clyster, whenever it is presumable that the compound formed by the oxyhydrate and the arsenic has reached the lower portion of the bowels. To aid this, cathartics may be administered. Of these, castor oil, which would first sug- gest itself, might interfere, it has been conceived, with the opera- tion of the antidote. The sulphate of magnesia, or any of the neutral salts, should have the preference. The antidote may be given suspended in water. Experience has shown Messrs. Bunsen and Berthold, that from ten to twenty parts of the hydrated oxide of iron are more than sufficient to convert one part of arsenious acid into the basic salt of iron. As the quantity of arsenic in the stomach and intestines can scarcely ever be appreciated, it is considered by them advisable to allow the patient to take as large doses of the oxyhydrate as the stomach can tolerate; and it is of essential importance that it should be taken as hot as it can be borne. When the arsenious acid has been swallowed in the undissolved state—in the form of powder, or in larger or smaller pieces—it is necessary, in order to aid its solution, and to effect a speedy union with the oxide of iron, to add a small quantity of pure ammonia to the antidote, until a slight alkaline reaction is evinced. As the ammonia does not enter into the composition of the salt formed, and, consequently, only plays a secondary part, ten or twenty drops may be sufficient for the purpose. The various experiments that have been instituted on animals have shown the protective power of the hydrated peroxide; it must be borne in mind, however, in all such experiments made on dogs, that they readily reject the poison by vomiting ; but if the poison be retained in the stomach by a ligature passed round the oesophagus, it exerts its accustomed deleterious effects.1 It would seem, also, that the same result occurs if the dose of the arsenic be too small to induce vomiting. The animal may then die of the poison.2 It would appear, that cases have occurred, in which this anti- dote has saved the lives of some who might have been destroyed without its agency. Buzorini3 had a case in which about thirty- 1 MM. Miquel and Soubeiran, Bullet. General de Therapeutique, Dec. 1834. See on this subject, Dr. Joseph E. Muse, in Amer. Med. Intelligencer, for April 2, 1838. 2 Dr. Robert B. Hall, in Amer. Med. Intelligencer, for Sept. 15, 1838, p. 181. 3 La Lancette Franchise, Nov. 17, 1835. 230 NEW REMEDIES. five grains of arsenic had been swallowed, and where it was suc- cessful, although twenty-four hours had elapsed since the poison had been taken ; but this cannot be regarded as very satisfactory, inasmuch as the patient might probably have been saved by ordi- nary means. In another case, which was also treated by the antidote at a late period, marked alleviation of the sufferings was induced. Three cases are, also, related by Majeste, two by Bineau,1 one by Benoist, and one by Geoffroy,3 of Paris, which were treated successfully in the same manner. The subject of the last was a hair-dresser, thirty-five years of age, who, in a pa- roxysm of delirium tremens, swallowed a dram and a half of arsenic. Half an hour afterwards the antidote was given, sus- pended in water. He drank, in twelve hours, all the tritoxide produced by the decomposition of five ounces and five drams of the tritosulphate of iron. He had no violent colic; and, twenty- four hours afterwards, experienced scarcely any uneasiness. A successful case has, also, been related by Mr. John Robson, house surgeon to the Warrington Dispensary.3 Dr. Richard H. Thomas, of Baltimore,4 has published a case, in which it was believed that twenty grains of arsenic had been taken, and which was relieved by the hydrated peroxide, adminis- tered six hours after the poison was swallowed: there was no vo- miting ; but thirst, burning pain, and exquisite tenderness at the epigastrium existed, denoting eso-gastritis. Half a fluid ounce of the hydrate, which was in the wet state, and about the consistence of thick cream, was given in a tumbler of cool water, and the dose was directed to be repeated every ten or fifteen minutes in two ounces of water: eight ounces of the suspended hydrate were taken in the twenty-four hours, after which the patient seemed free from disease. " The length of time—six hours"—says Dr. Thomas, "before any very severe symptoms supervened, and before the antidote was administered, at first caused me to think that the pa- tient might have been deceived. Professor Von Specs, of Vienna, however, asserts, 'that a dram of arsenic, in powder, does not pro- duce its deadly effects on the system in less than six or eight hours, while the same quantity, dissolved in warm water, destroys life in 1 Journal des Connaissances Medico-Chirurg. Nov. 1835. 2 Journal de Med. et de Chirurg. Pratiq. Sept. 1835; and Br. and For. Med. Rev. April, 1836, p. 572. 3 Lond. Med. Gazette, Nov. 5, 1836; also, Amer. Journ. of the Med. Sci- ences, p. 222, May, 1837. 4 Ameriean Medical Intelligencer for July 16, 1838, p. 167. FERRI PRiEPARATA. 231 a much shorter time.' In the present instance, it was swallowed in a dry state, covered with sugar. The prompt relief, which fol- lowed the exhibition of the peroxide, is also confirmatory of the impression that the poison was really taken." More recently, a case has been published by Dr. Deville,1 which was treated by this remedy, but as the patient vomited much, and the vomited matters were not examined, it is doubtful what was the agency of the oxide. Between five and six hours elapsed be- fore it could be procured. It has been recommended by Meuser, Riecke, and others, that the hydrated peroxide should be kept in the shops, ready mixed with a definite quantity of water, in order that it may be always at hand, so as to be administered without delay; and the recom- mendation is good. Even if not to be trusted to alone, the evi- dence is quite sufficient to show, that it ought to be regarded as an important element in the treatment of every case in which arsenic has been taken. Instead of the pure hydrated peroxide, Von Specs8 employed sub- stances in which the peroxide is known to exist in considerable quan- tity, and which require no previous preparation, as rust of iron, and hasmatite, (red iron ore,) and, from his experiments, he is led to conclude, that although these substances do not prevent all the bad effects of arsenic on the system, they may—in the absence of the hydrated peroxide—be employed as antidotes to that poison. The rust of iron has the advantage of being readily procurable. FILIX MAS. Synonymes. Aspidium Filix Mas, Athyrium Filix Mas, Polypodium Filix Mas, Male Fern. French. Fougere Male. German. Farrenkraut, Johanniswurzel. The root of the male fern has long been celebrated—since Dioscorides indeed—as an anthelmintic; and especially for the 1 Revue Medicale Franc, et Etrangere, Sept. 1838; see, also, Br. and For. Med. Rev., and Johnson's Medico-Chirurgical Review for April, 1S39; and American Journal of the Medical Sciences, May, 1839, p. 243. 2 Med. Jahrbucher des k. k. o. St. B. xix. S. 621. Wien, 1836; and Ibid. B. xx. S. 149. Wien, 1836. See, also, Br. and For. Med. Rev., July, 1837, p. 237; and Amer. Journ. Med. Sciences, Feb. 1838, p. 519. 232 NEW REMEDIES. destruction of taenia.1 For these properties, it has been introduced into most of the Pharmacopoeias. It was the basis of Madame Nouffer's celebrated remedy for taenia, which was purchased by Louis XVI. in 1775, for 18,000 francs. We notice it here, on account of the proposition of Peschier,2 of Geneva, to administer the ethereal extract, which has since been carried into effect, and apparently with the best results. It appears to possess the advantage of being by no means unpleasant to the taste, and to be accompanied by none of the disagreeable effects, that are associated with the action of most of the other vermifuges. To prepare the extract, the root is cut small, and digested for ten or twelve days, in the cold, in a sufficient quantity of sulphuric ether,—the tincture is then pressed, concentrated by distillation, and the ether thereby fully removed. From a pound of the root, about eighteen drams of a brownish green, thick extract are obtained, which possesses the repulsive odour of the plant, and has an acrid taste. In Germany, the extract is generally prepared according to the formula of the Prussian Pharmacopoeia, which is as follows—Take an ounce of the powdered root, and pour thereon eight ounces of the sulphuric ether of commerce ; close the vessel, shaking it occa- sionally, and let it stand until the fluid has acquired a yellowish colour; then separate the fluid as before described; distil off the sulphuric ether until only a third remains, and evaporate the remainder, in a water bath, until a thin brownish yellow coloured extract remains. This extract contains not only the volatile oil of the fern, but also a fixed oil, tannin, acetic and gallic acids, a muco-saccharine matter, green and red colouring matter, and a semi-resinous sub- stance. By some it is called the Oleum Filicis Maris. The active constituents of the fern are highly concentrated in it; and as the result of numerous trials, it was found, that from eighteen to twenty grains, given at night, and the same quantity in the morning fast- ing destroyed taeniae, so that on the administration of a cathartic, the parasite was discharged—often in the form of a ball. Not unfrequently, indeed, it was voided before the cathartic was given. In Germany, this new preparation has been chiefly recommended by Hufeland, who maintained, that in rapidity, certainty and gen- 1 Merat & De Lens, Diet, de Mat. Med. Art. Polypodium. 2 Nouvelle Bibliotheque Medicale, Sept. 1828, p. 151, and Bibliolh. Univer. xxxi. 324, 1826. FILIX MAS. 233 tleness of action, it exceeds all known means, and many other physicians have testified to the accuracy of this opinion. Radius,1 who frequently prescribed it, says he never gave it without bring- ing away large pieces of the worm, but frequently the head remained behind.2 Buchner3 thought, that the extract might be prepared with alcohol, but many physicians have objected to this menstruum,— that it does not dissolve the fixed oil. MODE OF ADMINISTERING. The extract is commonly given in the form of pill; emulsion does not answer, because the active constituents are apt to be enveloped and masked in this form. In Geneva, it is now fre- quently united with castor oil, this renders it unnecessary to give a cathartic after it. For the cathartic when needed, they advise in Bern, infusion of senna with epsom salts, manna, and aniseed.4 To children it may be given in syrup. Mel Filicis Maris. Honey of the Male Fern. St. Ext. aether, filicis maris, gss. Mellis rosat. jfss. M. Half of this to be taken on going to bed; the other half early in the morning fasting. Radius. 1 Auserlesene Heilformeln, u. s. w. Leipz. 1836. * See, also, Ebers, in Hufeland & Osann's Journal, Ixvi. St. 1. S. 43 and Gazette de Sante, Sept. 25, 1828. 3 Repertorium fur Pharmacie, xxiii. 433, xxvii. 337, and Funk, in medicin. Zeitung, Mai, 17, 1837, S. 102. 4 Hufeland und Osann's Journal, Ixiv. St. 1. S. 133. 30 234 NEW REMEDIES. FUCUS CRISPUS. Synonymes. Lichen Carrageen, Chondrus Crispus, Sphaerococcus Crispus, Ulva Crispa, Chondrus Polymorphus, Irish Moss, Carrageen or Corigeen Moss. French. Mousse d'Irlande, Mousse Perlee. German. Krauser Tang, Seetang. Although the carrageen or Irish moss has long been used in Ireland, it was but little employed in other parts of Europe, or in this country, until within the last few years. Of late, it has been used precisely in those cases in which the Lichen Islandicus, or Iceland moss has been deemed appropriate. In Germany, the first trials were made with it in the year 1833, by Von Grafe of Berlin, and the results were given to the world in his report for that year1 of the Clinical surgical and ophthalmic Institute, attached to the Frederick William University. The fucus crispus, which belongs to the natural family algae, exists in the Atlantic Ocean, on the coasts of England, Ireland, western France, Spain and Portugal, and as far as the tropics. It is also a native of the United States. It is met with more abund- antly, however, in Ireland, where it is used by the poor as an article of diet. It is thrown on the shore by the waves, and is gathered at the time of the ebb. The Irish moss, when fresh, is green, and somewhat resembles the Iceland moss ; but when dried, as we meet with it in com- merce, it is of a bright yellow, and resembles laminae of horn, crisped, translucent and frequently containing small shells, calca- reous concretions, and grains of sand. It has not much taste; the smell seems to betray iodine, which, however, has not been detected in it. When the moss is chewed, it feels like so much cartilage, but, by the moisture and warmth of the mouth, it soon loses its brittleness. It contains little sea salt, but a good deal of sulphate of soda.2 The jelly obtained from it is transparent and colourless; its taste is by no means disagreeable; it keeps several days, and is not con- verted by muriatic acid into mucus, like the jelly which is ob- tained from land plants. In its nature it is esteemed to be nearly 1 Bericht uber das klinische chir. augenarztliche Institut. der k. Friedr. Wilh. Univers. fur d. J. 1833. Berl. 1834. 2 E. Grafe in Art. Fucus, Encyclopad. Worterb. der medicinischen Wissenschaft. xiii. S. 1. Berlin, 1835. FUCUS CRISPUS. 235 allied to animal mucus.1 It is easy of digestion, is readily borne by weak and irritable stomachs, and exerts a soothing influence on the air passages and the intestinal canal. In order to obtain it, the moss is cut small, carefully cleared from impurities, boiled with the selected vehicle, and strained. Von Grafe obtained, from nine ounces of milk boiled with half a dram of the moss, five ounces of jelly ; and as much from a dram and a half of the moss and twelve ounces of water. The formula, commonly used by him, is given below. To this jelly may be added any dietetic or remedial agent, which may be considered indicated in the particular case.2 EFFECTS ON THE ECONOMY. The fucus crispus is used in the affections that are considered to be benefited by the Iceland moss. As a diet, it is given in con- sumptive cases, and wherever there is erethism in the respiratory or digestive apparatus. In diarrhoea it is sometimes given along with astringent or other remedies. The jelly has been advised as a diet in scrofulous cases. Von Grafe affirms that he has often found it serviceable in hoarseness, in dry spasmodic cough, consumption, diarrhoea, and dysentery, in the intestinal pain, which remains after inflammation and ulceration of these parts, and after poison has been taken ; in diseases accompanied by much emaciation, and in the prostration ensuing on serious diseases and operations. In similar affections it has been extolled by Hufeland.3 On the other hand, Heyfelder affirms that not only he, but many physicians of his acquaintance have used the moss without either good or evil results in phthisis, as well as in erethism of the respiratory and digestive organs ; and Riecke4 remarks, that as it makes a very agreeable jelly, when boiled with milk, and with the addition of a little of the aqua laurocerasi, it may do for cases where we must prescribe " ut fecisse aliquid videamur." The truth is that it can render no more service than other sub- stances which contain a similar principle, and accordingly but few 1 Lucae, in Riecke, Die neuern Arzneimittel, S. 234. Stuttgart, J837. 2 See L. Feuchtwanger, in Philad. Journ. of Pharm. vi. 204. Philad. 1833-4 s Hufeland und Osann's Journ. der practisch. Heilkund. B. 77 St. 5 p. 135. ' ' * Op. cit. S. 235. 236 NEW REMEDIES. prescribe it with any other view than as a demulcent and nutri- tious aliment, in cases where such is needed. MODE OF ADMINISTERING. Decoctum Fuci Crispi. Decoction of Irish Moss. St. Fuci crispi elect, et concis. gss. Lact. vaccin. recent, %ix. Coq. ad remanent, colatur. §v. Sacchar. albissim. §ss. ad^i. Aq. amygdal. amar. concentr. 9i. Adde To be taken in the course of the day. Von Graefe. St. Fuci crispi elect, et concis. ^iss. Coq. cum aq. font. §xij. ad remanent, colat. §v. Syrup, rubi. idsei ^iss. ad ^ij. Aq. amygd. amar. concentr. 9j. To be used through the day. When employed as diet Von Grafe allows from ten to eighteen ounces of the jelly in the day. St. Fuci crisp, (elect, et concis.) 3SS- Coque cum aq. font. q. s. ad reman. §vj. Colatur. adde Sodae phosphat. ^iss. Syrup opii, gij.ad ^iij. Dose.—A spoonful every two hours in cases of haemoptysis, between the attacks. Clarus. St. Lactis vaccini, §xxiv. Fuci crisp. 9iv. Sacch. alb. ^j. Cort. cinnam. cont. 9j. Coque per minut. x. leni igne; filtr. et exprime. Beral. St. Fuci crisp, (elect, et concis.) ^ij- Coque cum lactis ftj. ad consist, gelatin. Tere cum Sacch. alb. ^ij. Amygdal. amar. No. 2. To be used in the course of the day, and daily. Hufeland. FULIGO. 237 FULIGO. Synonymes.—Fuligo Splendens, F. Ligni, Soot, Woodsoot. French.—Suie. German.—Glanzruss, Spiegelruss, Kaminruss, Ofenruss, Russ. The discovery of creosote, and its extensive application to the treatment of disease, gave occasion to the resuscitation of this article—much employed by the ancients, but subsequently fallen into oblivion. The older physicians frequently used soot as an exciting, diaphoretic agent in cachexia of every kind, in chronic rheuma- tism, cutaneous affections, and especially in the evil results of their sudden repercussion; in glandular indurations, rickets, exostoses, &c. It has also been employed as a domestic remedy, in colic, and in the simple and dysenteric diarrhoea, and cholera of children. Several modern recommendations—as by Schutte and Weisenberg —remained unheeded until the attention of physicians was recently drawn to it, especially by Blaud.1 He is of opinion, that the costly —and by no means easily prepared—creosote may be wholly replaced by soot. Both are products of the dry distillation of organic substances; their odours are analogous, and as soot is much cheaper and more easily obtained, it deserves, he thinks, to be tried more extensively in therapeutics. The soot has a nause- ously empyreumatic, more or less bitter and acrid, saline taste. effects on the economy. Bland2 has exhibited the soot in different diseases, especially in the form of ointment, or in decoction, with excellent and rapid effects, in herpes, itch, tinea, gutta rosacea, and pruritus vulvae; and he asserts, that he even healed a cancer of the breast by fre- quent ablution with a tepid decoction of it, and an ointment com- posed of equal parts of lard and soot with one eighth part of the extract of belladonna ; but the same applications were of no benefit in a case of cancer of the nose, and in one of cancer of the uterus. 1 Revue Medicale, Juin, 1834 et Janvier, 1835, and Dr. E. Grafe, in Grafe und Walther's Journal, xxiii. 310. Berlin, 1835. 2 Journal des Connaissances Medico-Chirurg. Mai, 1834. 238 NEW REMEDIES. He also cured a scabby eruption of the mucous membrane of the nose by an ointment of soot. In diphtheritis, he used, in two cases, a decoction of soot as a mouth-wash with the best effects. In confirmation of Blaud's remarks, Voisin asserts, that he cured a case of cancer of the face by the soot ointment. Dr. J. R. Marinus1 has found it very efficacious in chronic erup- tions (dartres), and in tinea. Carron du Villards2 advises a collyrium prepared from soot in cases of strumous ophthalmia. He infuses two ounces of soot in boiling water, filters and evaporates to dryness; the shining resi- duum is then infused in very strong boiling vinegar, and to every twelve ounces of the liquid, twenty-four grains of extract of roses are added. A few drops of this solution, in a glass of tepid water, form an excellent resolutive collyrium, which may be made stronger or weaker at pleasure. He has, also, in cases of spots on the cornea, used soot—either blown into the eye alone, or mixed with powdered sugar-candy, and has seen good effects from it. United with butter it forms an eyesalve, not inferior, he says, per- haps to any other. As, in the treatment of specks on the cornea by dropping laudanum into the eye, the organ quickly becomes accus- tomed to it, Carron du Villards advises, that the eye should be excited to a more lively action by means of the combination of soot and tincture of opium given below. It is, he says, an energetic agent and may be applied by means of a pencil to the granulations on the cornea. He likewise recommends a decoction of soot as an injection in discharges which are the consequence of chronic in- flammation of the vagina. More recently, M. Andre Gibrin3 has detailed to the Academie Royale de Medecine of Paris, six cases of chronic inflammation of the bladder in which soot was beneficially used in the way of injection. He took from the chimney two ounces of compact soot, broke it up, washed it, and boiled it in a pound of water. The decoction was filtered through paper, and injected into the bladder twice a day. The good effects supervened so closely on the admi- nistration of the remedy, that there could be no doubt as to the cause. The pain ceased, and the patient obtained sleep, to which 1 Bulletin Medical. Beige, Nov. 1838, p. 289. 2 Gazette Medicale, Janvier, 1831; see, also, Baudelocque, on its use in Scrofulous Ophthalmia, in Bulletin General de Therapeutique. Mars, 1834. 3 Bulletin de l'Academie, 15 Mars, 1837. FULIGO. 239 he had been for some time a stranger. The urine gradually be- came clear, and recovered its natural appearance. To these remarks it may be added, that, according to Schiitte, an ointment composed of two parts of fresh butter or hog's lard, and one part of soot, is a popular and efficacious remedy on the Rhine for cases of porrigo, itch, and herpes ; not more than a dram being rubbed in at a time. Weisenberg ascribes to the soot a protective power against contagious affections of the skin, and recommends, especially, lotions of soot water,—partly as a preventive agent, and partly as a therapeutical application in itch. But the soot has not been used, of late, externally only; its inter- nal use, in the form of the old " tincture of soot," has been revived. This was long known under the name of " soot drops" and " fit drops," and was employed as an antispasmodic in hysterical and other affections; but its employment has been extended, and it is given in chronic rheumatism, chronic affections of the chest, sup- pressed cutaneous eruptions, in many cases under precisely the same notions that prevailed years ago. From thirty to sixty drops of the following tincture are given several times in the course of the day. MODE OF ADMINISTERING. Mistura Fuliginis. Tinctura Fuliginis (Clauderi.) Mixture of Soot. St. Fulig. splend. ,§ss. Potassa? carbonat. Jiss. Ammonia? carb. £ij. Aq. sambuc. %ix. Digere leni calore. Filtra. Dose.—From thirty to sixty drops several times a day. Lotio Fuliginis. Lotion of Soot. St. Fulig. splend. manip. maj. ij. Coque cum aq. font, fcj per semihoram. Cola cum expressione. Used as a wash, several times a day, in herpetic, psoric and syphilitic ulcers. Blaud. 240 NEW REMEDIES. Unguentum Fuliginis. Ointment of Soot. St. Fulig. splend. Adipis, aa. ^ss. Extract, belladon. 3J. M. exacte, To be spread upon lint or tents in cases of cancers. Blaud. St. Axung. porcin. Fulig. splendent, aa. §ij. Coque leni igne per horas vj. As a dressing in cases of tinea, and of foul ulcers. Blaud. St. Carbon, pulv. Sulph. depur. aa. 3j. Fulig. splend. Cort. Peruv. flav. aa. §ss. Cerati simplicis q. s. ut fiat unguentum. A dram to be rubbed in, once or twice a day, in cases of tinea. Carron du Villards. St. Opii,gij. Caryoph. arom. 3j. Fulig. splend. loti, ^ss. Aq. cinnam. ^viij. Alcoholis, %iv. Digest in a gentle heat for six days ; filter and express the residuum. Applied in cases of specks on the cornea. Carron du Villards. St. Fulig. ^ij. Album, ovi, No. vj. Tere simul. As a dressing for herpes and tinea. It is the Pommade resolu- tive of Sainte Marie.1 St. Fulig. 3iss. Zinci sulphat. ^vj. Adipis, |jiv. M. Applied in cases of tinea. It is the Pommade contre la teigne, of Bories.2 ' Nouveau Formulaire Medical et Pharmaceutique. Paris et Lyon, 1820. 2 Formulaire de Montpellier. Montpellier, 1822. GALEOPSIS GRANDIFLORA. 241 GALEOPSIS GRANDIFLORA; (SUMMITATES.) Synonymes.—Galeopsis Ochroleuca, G. Villosa, G. Segetum, Herba Side- ritidis. German.—Grossbluthigen Hohlzahns, Grossblumigte Hanfnessel. This plant, which belongs to the natural family Labiatse, and in the Linneean system to Didynamia Gymnospermia, grows in the western part of Germany, in sandy cornfields.1 EFFECTS ON THE ECONOMY. The fresh plant has a peculiar, feeble, balsamic smell, and a somewhat bitter and saltish taste, and has been considered, in Germany, to be worthy of a distinguished place amongst the "bitter resolvents." It has been much sold as a nostrum, under the name of "Blank- enheimcr Tea," (Blankenheimer Thee), or " Lieber's pectoral and phthisical herbs,'' (Liebersche Brust oder Auszehrungskrauter), and enjoyed ofreat repute. In the Ardennes, also, particularly in the district of Malmedy, it has been long employed as a popular remedy. In the year 1828, Lejeune2 directed attention to the therapeutical importance of this plant. According to his observa- tion, it is very useful in diseases of the mucous membrane of the respiratory and digestive organs, and especially in chronic pulmo- nary catarrh, even when it exists to such a degree as to merit the name Phthisis mucosa (Schleimschwindsucht.) In actual phthisis the affection seemed to him to be diminished by it; the hectic being moderated, the expectoration rendered easier, or the cough assuaged. Lejeune generally boiled half an ounce of the plant in a pint of water dovn to half; sweetened the decoction with sugar or honey, and directed the whole to be taken in the twenty-four hours. In other cases, in which a milk diet was appropriate, the decoction was made with an equal quantity of milk. Wesener3 found it advantageous in phthisis mucosa, and in chronic pulmonary catarrh. Giinther, who had many opportunities for observing the 1 Von Schlechtendal, in Encyclopad. Worterb. der medicin. Wissenschaft. xiii. 115. Berlin, 1835. 2 Annales Generates des Sciences physiques, p. 331. Sepr. 1820. 3 Hufeland und Osann's Journ. der pract. Heilk. 1823 and 1824. 31 242 NEW REMEDIES. action of the remedy, affirms, that the Lieberschen Krauter not unfrequently produced some amelioration in phthisis, especially in scrofulous phthisis, but he never saw any actual recovery there- from. It seemed to him to moderate the colliquative sweats, and to facilitate and diminish the expectoration. In one case especially, of scrofulous phthisis, in the last sta^e, it appeared to be of essential service, and to prolong life; and from all his observations he is disposed to infer, that if it is not the sole or the main remedy to be employed in every stage of phthisis, it may be used with advantage throughout the disease as a supporting agent. Riecke1 asserts, that he has seen many cases in which the Lieberschen Krauter were of great service in thoracic affections threatening phthisis. In one case, which promised to terminate unfavourably in a short time, owing to the complication of violent hsemoptysis with hectic fever, and in which an experienced phy- sician had exhausted every effort of art, they were given with the best effect. The thoracic affection ceased, and at this time—a period of five or six years since the use of the remedy—the patient —an officer—is capable of performing his military duties without difficulty. On the other hand, Richter affirms, that in two cases in which he administered the galeopsis, no benefit resulted from it. In this country it has not been employed ; so that we can only judge from the testimony afforded by the German writers. This, as they themselves admit,3 is not yet sufficient to enable them to lay down any positive rules as to the exact indications and counter-indica- tions that must regulate its employment. It is probably of no farther service than as a mild bitter, and its place may, therefore, be supplied, perhaps advantageously, by many of the tonics that are admitted into the lists of our remedial agents. Geiger3 sub- jected it to analysis, and found in it 2.765 parts of fatty matter, wax and chlorophylle; 0.247 of a brown bitterish resin, insoluble in ether; 0.312 of a yellowish stimulating and bitter resin, soluble in ether ; yellow bitter extractive matter, soluble in ether, and a brownish matter insoluble therein ; phosphate and malate of lime ; salts of potassa; muco-saccharine matter and fecula, and 65.882 of ligneous matter. 1 Die neuern Arzneimittel, u. s. w. S. 241. Stuttgart, 1837. 2 Op. cit. S. 241. 3 Magaz. fur Pharmacie, ix. 134. GENTIANINA. 243 METHOD OF ADMINISTERING. St. Sumraitat. galeopsid. grandif. 3j. Boil in a pint of water for a quarter of an hour and strain. To be used in the twenty-four hours. Wesener. St. Summitat. galeop. grandifl. Rad. althaBse, aa. ^j. ---glycyrrhiz. gij. M. The fourth part of this to be boiled in a pint and a half of water. To be used daily in chronic catarrh, and in the expectoration produced by the softening of pulmonary tubercles. Radius.1 The galeopsis versicolor, and the galeopsis villosa, which have also been examined by Geiger,2 appear to be possessed of the same virtues as the galeopsis grandifiora? GENTIANINA. Synonymies.—Gentianeina, Gentiania, Gentia, Gentianeine, Gentianinum, Gentianin, Gentianine. The peculiar bitter principle of the root of the gentiana lutea, or yellow gentian, was discovered at the same time by M. Henry,4 Chef de la Pharmacie centrale of Paris, and by M. Caventou. Their results, indeed, were so identical, that it almost seemed as if they had acted in concert, and they therefore agreed to furnish them conjointly. According to these gentlemen, the gentiana lutea contains—1. A very fugacious odorous principle; 2. A yellow bitter principle, (gentianine;) 3. A matter identical with birdlime ; 4. A fixed oil; 5. A greenish substance; 6. A free organic acid; 7. Uncrystallisable sugar; 8. Gum; 9. A yellow colouring matter; and, 10. Woody fibre.5 Schrader discovered, in addition, a resin- 1 Auserlesene Heilformeln, u. s. w. Leipz. 1836. 2 Allgem. med. Annalen, S. 1141. 1825. 3Richter's Specielle Therapie, B. x. S. 397. Berlin, 1828. 4 Journal de Pharmacie, torn. v. 8 Journal General de Medecine, torn, lxxiv, and Magendie's Formulaire. 244 NEW REMEDIES. ous and narcotic principle, and M. Planche affirms, that he de- tected the latter. METHOD OF PREPARING. Powdered gentian is digested in water in the cold. At the end of forty-eight hours a yellowish green tincture is obtained, which must be filtered, and the liquid be sufficiently concentrated by ex- posure to heat in an open vessel. It then forms, on cooling, a yellow crystalline mass, which possesses strongly the taste and odour of gentian. This mass is digested in alcohol, until it ceases to yield a lemon colour. The products of the washings are added together, and exposed to a slight heat; the yellow crystalline mass reappears, which, towards the end of the evaporation, becomes solid. The mass is very bitter. It is then redigested in weak alcohol, which redissolves all, except a certain quantity of oily matter. This last alcoholic solution contains, in addition to the bitter principle of the gentian, its odorous matter, and also an acid substance. By evaporating the liquor to dryness, dissolving the residue in water, adding a little well burned and washed magnesia thereto, and by boiling and evaporating in a water bath, the greater part of the odorous matter of the gentian may be driven off. The bitter acid is also taken up by the magnesia, and the yellow bitter principle remains partly free, and partly combined with the magnesia, to which it gives a beautiful yellow colour. The greater part of the bitter principle may then be obtained pure and isolated, by boiling the magnesia in ether, and evaporating the solution. If it be desirable to separate still more of the bitter principle, which the ether has failed to take from the magnesia, this may be done by digesting in enough oxalic acid to make the liquor acidulous. The acid unites with the magnesia, and the bitter principle which is set free may be obtained by the means above mentioned. Gentianine is yellow, inodorous, and possesses very strongly the aromatic bitterness of gentian, especially when dissolved in an acid. It is very soluble in ether and in alcohol; and may be sepa- rated from them by spontaneous evaporation, in the form of very small, yellow, needle-like crystals. It is much less soluble in cold water, which it renders, however, very bitter. Boiling water has more action on it. Its colour is much deepened by the dilute alka- lies, which dissolve rather more of it than water does. Acids weaken its yellow colour. Concentrated sulphuric acid carbonises it, and destroys its bitterness. When exposed in a glass tube to GENTIANINA. 245 the heat of boiling mercury, it is partly decomposed, and partly sublimed, in the form of small, yellow, crystalline needles. It does not sensibly change the colour of litmus paper, either when blue, or reddened by an acid, but seems to be neutral. Henry and Caventou esteem it an acid; Richard, an alkali. It would seem that the experiments of MM. Trommsdorf and Leconte have demonstrated decisively, that gentianine, prepared according to the process of M. Henry, cannot be regarded as the active part of gentian.1 Professor Dulk, of Konisberg, recommends the following process for separating it:—The coarse powder of the root is treated with alcohol; the alcohol is distilled off, and the residuum dissolved in water. The solution is filtered; and the undissolved matter, treated with ether, furnishes a clear tincture, from which, by spontaneous evaporation, is procured the gen- tianine of M. Henry, entirely insipid. The aqueous solution has a very bitter taste, and is fermented to separate the sugar, which cannot easily be done in any other manner. The liquid is then precipitated by the neutral acetate of lead; and the precipitate is separated: into the bitter liquid filtered is poured basic acetate of lead, and a little ammonia, to precipitate the combination of vege- table matter with the oxide of lead; but care must be taken not to add too much ammonia, because the latter, as a stronger base, will withdraw the vegetable matter from the oxide of lead. A yellow precipitate is obtained, which is washed in small quantities of water, as in a larger quantity the combination is decomposed. The precipitate is dissolved in water, and decomposed by a current of sulphuretted hydrogen gas. It is filtered, and the solution eva- porated, at a moderate temperature, to dryness: the residue is treated with alcohol, s. g. .820; filtered, and by evaporation a mass is procured, which presents no trace of crystallisation. This gentianine is a brownish yellow matter. Dried and tritu- rated, it affords a yellow powder, and possesses the bitter taste of the root in the highest degree. It is hygrometric ; almost insoluble in absolute alcohol; more soluble in common alcohol, and very soluble in water. It reddens litmus paper ; heated, it melts, swells up, and burns without any residuum. It contains no azote. In its reaction and relation to bases, it approaches the acids. 1 Journal de Pharmacie, Dec. 1838. 246 NEW REMEDIES. EFFECTS ON THE ECONOMY. Gentianine, according to the experiments of Magendie, is not possessed of any poisonous qualities. Several grains, injected into the venous system, produced no apparent effect. He himself swal- lowed two grains dissolved in alcohol, and the only inconvenience which he experienced, was an extremely bitter taste, and a slight sense of heat in the stomach. It does not seem to possess any ad- vantages over the gentian itself. MODE OF ADMINISTERING. Magendie recommends a tincture and a syrup. Either of them may be substituted for the officinal tincture of gentian, wherever the latter is considered to be indicated. The syrup he regards as one of the best bitters that can be prescribed in scrofulous affec- tions, and he asserts, that he has observed permanently good effects from it. He does not give the dose of the gentianine,—which Radius1 fixes at from one to four grains twice a day. Tinctura Gentianina. Tincture of Gentianine. St. Alcohol. 24° (.903) gj. Gentianin. gr. v. Digere. Magendie. Syrupus Gentianina. Syrup of Gentianine. St. Syrup, simplic. Bsj. Gentianin. gr. xvj. M, Magendie. ' Auserlesene Heilformeln, u. s. w. Leipz. 1836. GRANATUM. 247 GRANATUM (CORTEX RADICIS). Synonymes. Punica Granatum, Malogranatum, Pomegranate, (the bark of the root.) French. Grenadier, Balaustier. German. Granatbaum. (Granatwurzelrinde.) The Punica Granatum appears to be a native of the northern coast of Africa, whence it was transported to Italy at the time of the Carthaginian wars. It is now cultivated in all civilised regions, where the climate is sufficiently warm to allow the fruit to ripen. It belongs to the natural family Myrtaceae, and, in the Lin- naean system, to the class Icosandria, order Monogynia. All the parts of the plant contain more or less tannin. The bark of the root is externally of a yellowish gray or ash colour ; inter- nally it is yellow, and has an astringent taste. According to Latourde Trie,1 it contains wax, chlorophylle, a considerable quan- tity of resin, gallic acid, tannin, fatty matter, and a peculiar matter called Grenadine,—in German, Granatin. This grenadine is, in its pure state, of a white colour ; inodorous, and of a sweetish taste ; so much so indeed, that, according to Magendie, it might be presumed to be a variety of sugar, except that it differs from ordinary sugar in being devoid of the property of fermenting. According to the degree of its purity, it crystallises in grains, tufts or stars. When thrown on red-hot coals, it consumes without any residuum, and smells like burnt bread. It is fusible, and by a moderate heat may be almost wholly sublimed. It neither reacts as an acid nor an alkali, and is readily soluble in water. Cold alcohol dissolves only traces of it, but boiling alcohol dissolves it readily,—a property, which is to be taken advantage of in the formation of crystals. In ether it is insoluble. Nitric acid, with the assistance of heat, converts it into oxalic acid. An ounce of the bark yields six grains of the grenadine; but it is not settled, whether it contains the whole of the medical properties of the bark. Cenedella,2 from whom we have the most recent analysis of the bark of the pomegranate root, also found the grenadine discovered by Latour. This substance is readily prepared. The bark in 1 Journal de Pharmacie, Fev. 1828, p. 109. 2 Giornale di Farmacia, Agosto, 1831, p. 55. See, also, Journal de Phar- macie, ix. 219; x. 352; and xvii. 503 ; and Prof. Dierbach, in Heidelberg. klin. Annalen, B. x. H. 3, S. 365. Heidelb. 1834. 248 NEW REMEDIES. powder is treated with ether, and afterwards with boiling alcohol, and the fluid is evaporated to the consistence of a soft extract. By treating this extract with water, the grenadine is dissolved without difficulty, and it may be purified by suffering it to crystallise fre- quently from alcohol. EFFECTS ON THE ECONOMY. The therapeutical properties of the different parts of the pome- granate tree were known to the writers of antiquity. They employed not only the bark of the root as a remedial agent, but also the flowers (Flores Balaustiorum, Balausles, Balaustia,) " Balaustine Flowers," the whole fruit (Poma Granati, Malo- Granata, Granata, Mala Punica, Fr. Grenades.) " Pomegra- nate ;" the rind of the fruit (Malicorium, Malichorium, Mala- corium,) and the seeds. Dioscorides, Pliny, Celsus and Marcellus Empiricus speak of the employment of the bark of the root in taenia.1 In more modern times, the Punica granatum had been greatly neglected, although the juice of the fruit was recommended by Frederick Hoffman against worms in children. In India, it has been long held in great estimation as a remedy in cases of tape- worm, and its efficacy having been noticed by some English physi- cians, it was recommended to the attention of European physicians, especially by Buchanan,2 Fleming and Breton.3 About the same time, a monograph was published by Gomez, a Portuguese physi- cian, which appears to have had considerable agency in extending the reputation of the remedy, especially in Germany, where the monograph was translated into the Journal of Gerson and Julius.4 Gomez directs two ounces of the fresh rind of the root to be boiled in a pint and a half of water down to a pint; and of this decoction two or three spoonfuls to be taken for a dose ; the first early in the morning fasting, and then every half hour until the whole is used. The efficacy of the preparation he tested on fourteen cases, from which it appeared, that the worm could not withstand the action of the remedy more than forty-eight hours. He found it to exert most efficacy, when portions of the worm were perceptible in the 1 Merat & De Lens, Diet, de Mat. Medical. Art. Punica Granatum. 2 Edinb. Med. and Surg. Journal, iii. 22, 1827. 3 Medico-Chirurg. Transact, xi. 31. * Magazin, u. s. w. vi. 427, and Journal Complementaire des Sciences Medicales, xvi. 24, 1823. GRANATUM. 249 evacuations, a period when the patient generally suffers most in- convenience. If the exit of the worm did not take place on the first day, after the use of the agent, the decoction was continued on the second day, when the worm was generally discharged. Did this, however, not happen, a farther continuance of the remedy was of no avail; and he thought it better to intermit it until the appearance of fresh portions of the worm in the evacuations. Gomez also administers the dried rind in pills. If the dose be too large, or the appropriate dose be too frequently repeated, nausea, vomiting and diarrhoea at times supervene; should this be the case, the proper course is obvious. In countries, where the fresh rind can be obtained, Gomez advises, that it should be used ; in colder countries, the dried rind, which is obtained from more southern regions, will have to be employed. According to Breton, the latter acts more powerfully; the dried rind loses more than half its weight, and two ounces of it may be esteemed equal to three of the fresh. The strong testimony, adduced in its favour by Gomez, gave occasion to numerous trials with it in England, France, Germany and Italy, which were generally attended with favourable results. Such favourable testimony has been afforded by Boiti, Marchese, Calabro, Majoli, Chevallier, Deslandes, Merat,1 Pichonnier, Man- drux, Claret, Bayle, Delaporte, Gendrin, Grimaud, Chapotin, Bourgeoise, Housson, Goupil, Ferrus, Wolff, Kostler, Meisinger, Berthold, and others.2 On the other hand, Keibel3 complaiws of its uncertainty; and, in the Polyclinical Institute of the University of Berlin, it was given without advantage; but Osann, in his report of that institution, is disposed to refer the want of success to some imperfection in the rind employed, which, he remarks, is found to vary greatly in its character, as met with in the shop of the apothecary. It would appear, also, that it is not unfrequently mixed with the rind of the root of the Boxtree, and the Guelder rose (Wasserholl under.) To introduce more precision on this matter, Wolff recommends that the druggists should purchase the bark of the root of the 1 Du Taenia &c. et de sa cure radicale par l'ecorce de la racine de Grena- dier. Paris, 1832; and Merat & De Lens. Op. cit. 2 Riecke, Die neuern Arzneimittel, S. 247. 3 Rust's Magazin, xvi. St. 3. S. 566. 32 250 NEW REMEDIES. genuine East India, or at all events the Portuguese, tree. Boiti1 advises that the root should be obtained from mountainous regions, where the tree grows wild ; that it should be taken only from young trees, and that it should not be more than an inch thick, that it should be carefully separated from the woody portion, and be col- lected in the spring of the year, when the tree has most sap, and be dried in the shade. Chevallier,2 also advises, that only the rind of the root of the wild tree should be used. Gendrin, Montault and Pichonnier all affirm, that the fresh rind was alone certain in its operation ; the dry frequently disappointing them. According to Breton, the rind of the trunk is to be preferred to that of the root, because it preserves its virtues longer. Chevallier recommends, before the decoction of the pomegranate tree bark is administered, that a gentle cathartic of castor oil with lemon juice should be premised. This may be taken the evening before, the patient fasting during the following day. The decoction he directs to be made of two ounces of the rind macerated for twenty-four hours, in two pints of water, and then boiled until a pint of the strained liquor remains. This must be divided into three portions, which are taken in half hourly doses. The first and second doses with many persons excite vomiting, but this need not prevent the ad- ministration of the third, as it rarely produces the same effect. This quantity of the decoction commonly occasions three or four evacuations, preceded by slight colic pains; at other times, but one evacuation is produced, with which the worm is usually expelled. The period that elapses between the administration of the last dose of the remedy and- the commencement of its operation is from a quarter of an hour to a whole hour—rarely longer. Cenedella advises that the bark of the root should be macerated before boiling; that the decoction should be made in earthen, not in metallic, vessels, and that it should be filtered or strained whilst hot, different constituents—which are probably efficacious—being deposited as the liquor cools. According to Constant, the rind is commonly prepared in France in the following manner. The rind of the fresh root—or the bruised root dried—is mace- rated through the night in from a pint and a half to a quart of water; the liquor is then boiled to one half, strained, and in the morning, a third part is taken lukewarm, fasting, and repeated 1 Revue Encyclop. xxxii. 234. 2 Journal de Chimie Medicale, i. 378; 1825. GRANATUM. 251 every three hours until the whole has been administered. The quantity of the rind, used for the decoction, is, in the case of the adult, I]; of children, from six to fifteen years old, 3vj ; and of those under six years of age, §ss. At times, however, it has been ad- ministered in much larger doses. A girl, twenty-four years of age, had suffered from taenia from her infancy and had frequently passed fragments of worms in her evacuations. She took two ounces of the bruised bark of the pomegranate root, boiled in two pounds of water, at thrice, with half an hour's interval between the doses, but without effect. The dose was now increased to three ounces, and two tapeworms were expelled; so that in two days, and without any abdominal disturbance, the patient took the decoction of five ounces of the bark of pomegranate root.1 To ensure the proper action of the decoction, it must be given as directed above, without the addition of sugar or syrup, which changes its properties. During its operation, the patient should drink nothing, except when the tormina are urgent, and then a little of any aromatised water, without sugar, may be taken. The remedy should be given only on days in which portions of taenia are evacuated, or on the following morning; and the alimentary canal should be free from every evidence of inflammatory irritation. By some, as by Latour de Trie, and Ferrus, an infusion of the rind has been found serviceable ; and Deslandes recommends an Ex- tractum spirituosum, and an Extractum aquosum corticis radicis granatorum. Ferrus, Berthold, Goupil, and others, have published cases in which, along with the expulsion of the taenia, various neuroses were removed under the use of the rind, and accordingly it has been thought, that it might be usefully employed in such affections where no taenia exists ;—in epilepsy and hysteria, for example. Decoctum Corticis Radicis Granati. Decoction of Pomegranate Root Bark. St. Corticis radicis granati, ^ij. Aquae, Bij. Boil to a pint and a half. Dose.—gij every half hour. Three or four doses are usually 1 Professor Forget, in Gazette des Hdpitaux, Fev. 19, 1839, and Lond. Med. Gazette, Apl. 20, 1839. 252 NEW REMEDIES. sufficient to expel the worm.1 The formula, quoted by Dr. Paris3 from Dr. Ainslie's Materia Medica of Hindoston, directs the decoc- tion to be prepared with §ij of the fresh bark, boiled in a pint and a half of water, until only three quarters of a pint remain. Electuarium Corticis Radicis Granati. Electuary of Pomegranate Root Bark. St. Extract, spirit, cort. rad. granat. ^vj. Aquae fiorum tiliae* Succi. citr. aa. ^iij. Gum. tragac. q. s. ut fiat electuarium. Dose.—One half, from half hour to half hour. Deslandes. Mistura Extracti Corticis Radicis Granati. Mixture of Pomegranate Root Bark. St. Extract, spirit, cort. rad. granat. ^vj. Aquae menthae, Aqua? flor. tiliae,3 Succ. citr. aa. ^ij. M. To be divided into four parts, one of which may be taken every quarter of an hour. Deslandes. GUACO. Synonymes.—Huaco, Eupatorium Huaco. It would appear, that owinar to some extracts in the Allgemeine Zeitung, the attention of the German physicians had been directed to this article as an important agent in the cure of epidemic cho- lera; and various testimonials have been brought forward in its favour, which, as Riecke4 properly suggests, may not be confirmed by farther experience, and yet the circumstance may have led to the introduction of a valuable article into the catalogue of medi- cinal agents. 1 Jourdan's Pharmacopee Universelle, i. 638. Paris, 1828. 2 Pharmacologia, Beck's American Edition, p. 380. New York, 1831. 3 Any simple aromatic water may be substituted for this. 4 Die neuern Arzneimittel, u. s. w. S. 250. Stuttgart, 1S37. GUACO. 253 Many species of the genus Eupatorium, and of the kindred genus Mikania,—which has been recently separated from it, be- longing to the natural family Compositae, (Synanthereas, sub- division Corymbiferae,) and, in the Lynnasan system, to Syn- genesia iEqualis, have been prized in various parts of America, especially in cases of the bites of serpents. This is especially the case with the Eupatorium ayapana, (E. triplinerve.) According to Martins, a quantity of the bruised leaves is applied to the scari- fied wound, and the application of fresh leaves is renewed, over and over again, until thy patient is freed from the dangerous symp- toms, and especially from the violent suffering. At the same time, a few spoonfuls of the expressed juice are administered every now and then. The Mikania opifera, (Eupatorium crenatum,)—in Brazil termed Erva da cobra—and the Eupatorium satureja- folium, (Mikania saturejafolia,) also belong to the many Synan- therese, which, in South America, are reputed specifics against the bites of serpents. The most important species appears to be that called, in Peru, Guaco, or Huaco, which is held there in high con- sideration, as well as in Colombia, New Grenada, and Venezuela, not only in these cases, but in the prevention of hydrophobia.1 This is presumed to be the mikania guaco of Humboldt. The guaco was made known to us, forty or fifty years ago, by Mutis,2 who refers to its effects in cases of the bites of serpents. EFFECTS ON THE ECONOMY. Of the efficacy of the guaco in the Indian cholera, M. E. de Chaniac, Officier de Sante in the French navy, and Dr. Chabert, physician to the military hospital in Mexico, have published the results of their experience. When the brig Adonis, on her voyage from Havana to Mexico, in the year 1833, arrived at Vera Cruz, some of her crew were attacked with the cholera, which prevailed at the time in Mexico. Of all the remedies employed, the guaco was found the most beneficial; its effects, indeed, were so wonderful, 1 See W. R. Johnson, in Silliman's Journal, xxiv. 279 and 388, New Haven, 1833; and Ibid, xxvii. 17], New Haven, 1835; also, Dr. Hancock, in Quarterly Journal of Science, &c. from January to June, 1830, p. 333. Dr. Hancock affirms, that the names Guaco and Bejuco de Guaco were given—in the parts of America where he sojourned—to different species of Aristolochia. * Vrirey, in Bulletin de la Societe de Pharmacie, vi. 241; and Riecke, Op. cit. 251. 254 NEW REMEDIES. that it was regarded almost as a specific. Its action is chiefly ex- erted on the heart and the circulation, which it renders more energetic. All the patients, to whom it was exhibited in the com- mencement of the disease, were saved, and even of those, in whom the cholera had already reached a certain stage, the greater part were saved, as soon as a free and complete reaction was esta- blished. Dr. Chabert, who first administered the guaco in cholera, as well as in yellow fever, observes on its use in the former disease:—In simple cases, a small tea-cupful of a warm decoction of guaco was given every half hour, until a general diaphoresis and proper warmth of surface supervened, which was kept up for some days, when the remedy was gradually discontinued. To allay the thirst, the decoction was given, diluted with two-thirds, or half, water. In dangerous cases of cholera algida, with coldness, loss of pulse, &c, a spoonful of the spirituous tincture was mixed with six or eight spoonfuls of water, and, every quarter of an hour, a spoonful of this mixture was given alternately with a small cupful of the decoction. When the pulse returned, the warmth became restored, and the perspiration re-established; the tincture was omitted, and the de- coction continued alone at longer intervals. In the majority of cases, after the cessation of the cholera symptoms, pain was expe- rienced in the epigastrium, with burning thirst, which yielded when the decoction was diluted with half or two-thirds water. When the decoction could not be retained by the stomach, it was given in clyster. Bloodletting, general and local, was employed along with other external means, but nothing was given internally, except the guaco. To make the decoction ;—two drams of the stalks, and half a dram of the leaves, were boiled in two pints of water, down to one. The tincture was prepared like other tinctures. In consequence of the communications of Chabert and De Cha- niac, as well as of the parallel drawn by Harless,1 between the cholera and the effects of the bites of serpents, Professor Beckers, of Miinchen, recommended that experiments should be made with the guaco; and it was accordingly tried in Miinchen, but not with as favourable results as had been expected. Romerio asserts, that it was given in the stadium asphycticum, in the form of infusion, made of half an ounce of the stalks, but with uncertain results. It appeared to combine the effects of the valerian and ipecacuanha, yet 1 Die Indische Cholera u. s. w. Braunschweig, 1831. GUACO. 255 it excited less vomiting than the latter. The tincture appeared to render greater service. It was given in the dose of a coffee- spoonful every half hour, and, subsequently, every hour, and every two hours. It would appear, that in the district of Prague, its administration was attended with very favourable consequences.1 To account for the different results, it is affirmed, that different drugs are met with in commerce under the name guaco. Riecke says, that M. Jobst had sent him two kinds, which were evi- dently from different plants; the one variety was obtained from Hamburg'and Bordeaux, the other from Paris; descriptions of which are given by Riecke. The truth, probably, is, that this, like most of the cholera specifics which have been brought forward, is efficacious in certain cases of the disease, but that its efficacy has been egregionsly exaggerated. HIPPOCASTANUM, (CORTEX.) Synonymes.—iEsculus Hippocastanum, Castanea Equina, C. Pavina, Hoise Chestnut, Buck Eye, (the Bark.) French.—Marronier, Marronier d'Inde. German.—Rosscastanien, (Rinde.) The tree, whence this bark is derived, is the JEscidus Hippo- castanum, or Horse Chestnut—of the natural family Hippocas- taneas; in the Linnaean system, class Heptandria, order Mono- gynia—which is wild on the mountains of Asia Minor and Persia, and grows in this country, as well as in Europe. The bark has a very astringent taste, is somewhat bitter, and contains a great deal of tannin. Canzoneri thinks he discovered a peculiar principle in it, which he calls JEsculine, but the existence of this is contested. EFFECTS ON THE ECONOMY. The cortex hippocastani has long been advised as an astringent, but without receiving much attention.2 In modern times, it has been proposed by Zannichelli, Hufeland, Voigtel, and others, as ' Riecke, Op. cit. S. 256. 2 Merat & De Lens, Art. iEsculus Hippocastanum. 256 NEW REMEDIES. the best substitute for the cinchona. These recommendations have caused the bark to be more frequently administered of late, in Europe, by which means it has been discovered to accord almost entirely in its effects with the willow bark; the latter, however, appears to be more effective, and to agree better with the digestive organs. In the wars of Napoleon, when bark was very scarce, it was much employed. Hufeland and Voigtel recommend it, especially in intermittents. Sinogowitz1 advises that it should be given after the removal of intermittents by the quinine, to prevent a relapse; and, also, in combination with diuretic agents, in the cases of dropsy which often succeed that disease. Krugelstein found it always extremely efficacious in atonic gout, and in removing the weakness of the digestive apparatus that remains after attacks of gout. The Austrian, Brunswick, Danish, Russian, and Saxon pharmaco- poeias2 have an aqueous extract of the bark, which Voigtel admi- nistered with good results in intermittent fever, and which he often found serviceable in chronic discharges from the mucous mem- branes. It agrees better with the stomach than the powder or the decoction. Externally, the decoction has been advised as a good astringent. MODE OF ADMINISTERING. Decoctum Corticis Hippocastani. Decoction of Horse Chestnut Bark. St. Cort. hippocastan. fiss. Coque cum aquae commun. ixviij. ad reman, colat. gix; cui refrigerat. adde Spir. sulph. sether. 3j—ij. Syr. cort. aurant. §j. M. To be used during the apyrexia. Voigtel. Pulvis China Factitius. Factitious Powder of Bark. 5<. Cortic. hippocast. ----salic. ----gentian, rubr. Calara. arom. Caryophyll. aa. gij. Misce et fiat pulvis. 1 Rust's Magazin, B. xxix. H. i. p. 84. 2 Pharmacopee Universelle, ii. 14. Paris, 1828. HIPPOCASTANUM. 257 Hufeland1 affirms, that this powder is an adequate substitute for the cinchona in three cases out of four. Hufeland, and Prussian Pharmacopoeia. Decoctum China Factitia. Decoction of Factitious Bark. St. Pulv. gross, cort. salic. -------------hippocast. aa. ^ss. Rad. calam. Caryophyll. aa. jij. Coque cum aq. fontan. ^xvi. ad reman, colat. ifviij. Prussian Pharmacopoeia. Decoctum Hippocastani Acidum. Acid Decoction of Horse Chestnut. St. Cort. hippocast. pulv. sjvj. Coque cum Acid, sulphur, dilut. 3j et Aquae font. %x. Ad colat. ^vj. Used in the after treatment of intermittents. Sinogowitz. Electuarium Corticis Hippocastani. Electuary of Horse Chestnut Bark. St. Cort. hippocast. pulv. ^ss. Rad. calam. aroraat. ^ss. Roob. juniperi, giij. M. fiat electuarium. A tea-spoonful to be taken every hour, or every two hours in dropsies supervening on intermittent fever. Sinogowitz. 1 Armenpharmacopoe. 4te Ausgab. Berl. 1825. 33 258 NEW REMEDIES. HYDRARGYRI PRiEPARATA. Synonymes.—Preparations of Mercury. French.— Les Preparations de Mercure. German.—Quecksilberpraparate. I. HYDRARGYRI BROMIDUM. Synonymes.—Hydrargyrum Bromatum, Bromide of Mercury. German.—Bromquecksilber. Mercury unites with bromine in more than one proportion. A solution of hydrobromate of potassa produces, with a solution of nitrate of protoxide of mercury, a white precipitate, which resembles calomel; and appears to be a bromide of quicksilver, answering to the protoxide ; (Hydrargyrum Bromatum, Hydrargyri Proto- bromidum; German, Q,uecksilberbromur.) On the other hand, the bromide which is formed by the direct union of bromine with mercury, corresponds probably to the peroxide. A white substance results, which can be sublimed by heat, is soluble in water, alcohol, and especially in ether; is coloured red or yellow by the alkalies, and exhibits considerable resemblance to corrosive sublimate; (Hydrargyrum perbromatum, H. perbromidum, H. deutobromi- dum. German, Quecksilberbromid.) EFFECTS ON THE ECONOMY. The effects of these preparations on the sound and diseased organism are not yet well known. They have, however, been employed by some physicians. The protobromide strongly resem- bles calomel in its properties. In the dose of one or two grains, it produces no effect in health, even when taken fasting. In a higher dose—four or five grains, and upwards—it purges moderately, augmenting, at the same time, the secretion of urine. When used in recent syphilitic affections, in the way of friction on the gums, or internally, in the form of pill, it cures them like calomel; but it does not seem to affect the mouth as speedily or as severely as calomel.1 The deutobromide resembles the bichloride of mercury in its 1 Bulletin General de Therapeutique, No. 14, Juillet 30, 1837. HYDRARGYRI BR0MIDUM. 259 action,—producing, in too strong a dose, vomiting and purging, with colic and cramp of the stomach; affecting the mouth, and exciting violent salivation. Werneck, of Austria, has administered it frequently in syphilis. In recent cases, he prescribes the deuto- bromide in the form of pill, beginning with the one-twentieth of a grain. This dose he increases by two twenty-fifths every two days; the chancres being covered at the same time with compresses, wetted with a solution formed of six grains of the same substance to a pint of distilled water. After a few days' treatment, he re- marked, that the sores assumed a better appearance; and from twenty to thirty days were sufficient to effect their entire cicatrisa- tion : the total quantity of the bromide administered was about five grains. It was rarely necessary to carry it as high as ten or twelve grains. It has been believed that the deutobromide of mercury is less liable to affect the salivary glands than the deutochloride of mercury, and to affect less severely the stomach and chest.1 Desorgues has recommended the second (?) preparation as a pro- phylactic and curative agent in syphilis. It was, doubtless, also, Riecke suggests—the second preparation, which was administered with excellent effects by Prieger, in porrigo favosa, of an obsti- nate character. He terms the preparation bromas mercurii, but the true bromate is probably insoluble in ether.2 The first of the following formulae is recommended by Prieger. Gutta Hydrargyri Perbromidi. Drops of Perbromide of Mercury. St. Bromatis mercurii, (vel potius hydrargyri perbromidi,) gr. vj. Solve in iEther. sulphuric, jiij. M. Dose.—Ten to twenty drops, according to the age of the patient, daily, in water. / St. Hydrargyr. deuto-bromid. gr. j. iEther. sulphuric. £j. M. Dose.—Ten to twenty drops in barley water, a short time after taking dinner ;—in syphilis. Werneck. 1 Bulletin General de Therapeutique. No. 14, Juillet 30, 1837. 2 Die neuern Arzneimittel, S. 261. Stuttgart, 1837. 260 NEW REMEDIES. II. HYDRARGYRI CYANURETUM. Synonymes.—Hydrargyri Piussias, H. Bicyanidum, H. Borussias, Hydrar- gyrum Cyanogenatum, H. Hydrocyanicum, Cyanide, or Prussiate, or Hydrocyanate, or Bicyanide of Mercury. French.—Cyanure ou Hydrocyanate ou Prussiate de Mercure. German.—Cyanquecksilber, Blaustoffquecksilber, Blausaures Q,uecksilber. This mercurial preparation is contained in the pharmacopoeias of the United States, Dublin, London, Belgium, Paris, Ferrara, &c. METHOD OF PREPARING. According to Proust and Gay-Lussac, two parts of good and finely powdered Prussian blue must be boiled with one part of deutoxide of mercury and eight parts of water, until the mixture acquires a bright yellowish tint. It is then filtered; and the filtered liquor, which is the hydrocyanate of deutoxide of mercury—con- taining, however, some iron—is digested or boiled with an excess of the deutoxide of mercury, whereby the oxide of iron is com- pletely precipitated. As, however, the hydrocyanate is combined with an excess of the oxide of mercury, this must be saturated with free hydrocyanic acid, and the solution be evaporated to induce crystallisation. In this mode the cyanide is formed. The formula of the Pharmacopoeia of the United States, into which the cyanuret has been introduced to serve in the preparation of the hydrocyanic acid, is the same as that adopted in the Codex Medicamentarius of Paris, which was recommended by Berzelius. It is as follows :— Take of red oxide of mercury, three ounces; ferrocyanate of iron, (Prussian blue,) six ounces ; distilled water, three pints. Put the oxide of mercury and the ferrocyanate of iron, previously pow- dered and thoroughly mixed together, into a glass vessel; and pour upon them two pints of the distilled water. Then boil the mixture, stirring constantly, till it becomes of a yellowish colour ; after which filter through paper. Wash the residue in a pint of the distilled water, and filter as before. Mix the solutions, and evaporate by the fire till a pellicle appears ; then set the liquor aside that crystals may form. To purify the crystals, dissolve them again in dis- HYDRARGYRI CYANURETTJM. 261 tilled water; filter ; evaporate the solution, and set it aside to crystallise.1 The former of these methods is, doubtless, the best, as it ensures uniformity, whilst the Prussian blue of commerce being of variable strength, the cyanuret, made after the latter formula, must be so likewise. Schrader directs it to be prepared by mixing a solution of the red oxide or deutoxide of mercury with hydrocyanic acid, filtering and evaporating.2 The cyanuret of mercury forms white, opake, four-sided prisms. It is inodorous, and its taste is extremely disagreeable and metallic. It is decomposed by heat; is readily soluble in water, and becomes converted thereby into hydrocyanate of mercury. It is insoluble in alcohol. The cyanuret of mercury contains, at times, ferrohydrocyanate of potassa, proceeding from the Prussian blue, with which it has been prepared.3 EFFECTS ON THE ECONOMY IN HEALTH. According to Coullon, the poisonous action of the cyanuret of mercury is as rapid as that of the hydrocyanic acid; but, in the dose of from two to five grains, M. Ittner found it produce on dogs only signs of indisposition, tremors, &c.4 It is one of the sub- stances which Magendie," in his experiments, found to promote the coagulation of the blood. EFFECTS ON THE ECONOMY IN DISEASE. Parent,5 who frequently used this preparation, prefers it greatly to corrosive sublimate, in consequence of its greater solubility, and the capability of more readily affecting the organism by it. In his 'Wood and Bache's Dispensatory, Art. Hydrargyri Cyanuretum; see, also, Mr. Ellis, in Journal of the Philadelphia College of Pharmacy, vi. 24. Philad. 1834-5. * See a new process for its preparation, by MM. Chevallier and Deles- champs, in Journ. de Chimie Medicale, Janv. 1830. 3 Orfila, Toxicologic, i. 331. 4 Merat & De Lens, Diet, de Mat. Med. Art. Cyanogene. 6 Lecons sur le Sang; and translation in Lond. Lancet, Jan. 20th, 1839, p. 636. 6 Journ. de Chimie Medicale, viii. 473. 262 NEW REMEDIES. experience, syphilis yields more readily under its use than under that of any of the mercurials. He did not observe pains in the abdomen accompanying its protracted employment, which he so frequently witnessed when the sublimate was taken. Another ad- vantage which it possesses, is, that it is not so readily decomposed. No salt, no alkali—not even caustic alkali—disturbs it; neither do substances that contain azote or gallic acid, which speedily con- vert the sublimate into calomel. Moreover, the cyanuret of mercury appears to act on the animal textures differently from sublimate. When the latter is placed in contact with flesh, it becomes quickly changed, in part, into calomel; whilst the cyanuret preserves the flesh equally well, without being decomposed. The hydrocyanic acid appears to play no important part in the action of the remedy. According to Olivier's experiments,1 the cyanuret, like the corro- sive sublimate, acts as a powerful excitant to the tissues on which it is applied. He saw a man destroyed by inflammation of the in- testines, who had taken twenty-three grains of it. The cyanuret of mercury was first, perhaps, recommended in Italy, (Brera), and Spain. Mendoza especially made many trials with it, from which he was induced to conclude, that it is the best agent we possess in venereal affections—an opinion in which he was joined by several of his professional brethren in Malaga. He advises, that laudanum should be added to it, on account of its lia- bility to excite vomiting. When too large doses were administered, or when the patient was unusually impressible, Mendoza found that the nervous system became especially disordered—as indicated by syncope, oppression, anxiety, and convulsions. Chaussier, likewise, as well as .Thaer and Horn proposed the cyanuret as a remedial agent at an early period. On the other hand, Wendt, Cullerier, and Plisson complain of its little efficacy; whence it has been inferred that the preparation must differ; when prepared, in- deed, according to the first form, it always contains more or less iron.2 Neumann3 advised it in chronic inflammation of the lungs, and of the membranous organs of the chest, abdomen and ovaries. In particular cases, its use has to be soon pretermitted, in consequence of its powerful action, even in small doses—as one eighth of a grain three times a day—on the salivary glands. In other cases, it can 1 Journal de Chimie Medicale, i. 269. 2 Riecke, Die neuern Arzneimittel, u. s. w. S. 264. Stuttgart, 1837. s Hufeland und Osann's Journal, lv. 66. HYDRARGYRI CYANURETUM. 263 be continued long without the supervention of any unpleasant con- sequences. In the Charite, at Berlin, it was used with advantage in a case of obstinate cephalalgia, the origin of which was syphi- litic. Biett has employed it externally—in the form of the ointment given below—in cases of humid tetter, accompanied with inflam- mation and itching. Parent recommends it to be applied in cases of chancre, and Brera uses it in solution, as a gargle, in syphilitic ulceration of the fauces. MODE OF ADMINISTERING. The cyanuret of mercury may be given in pills or in solution ; Horn gave it in powder, but this form is less appropriate. The dose is from one sixteenth of a grain to a grain several times a day. As a gargle, half a grain to a grain may be dissolved in gj of wa- ter ; as an ointment from one and a half to two grains to 3j of lard. Chaussier used it in friction on the soles of the feet, in the same way as the corrosive sublimate. Solutio Hydrargyri Cyanureti. Solution of Cyanide of Mercury. (Synonyme.—Liqueur Antisyphilitique de Chaussier.) St. Hydrargyri cyanuret. gr. viij. Aquae distillat. B5j. Each ounce contains half a grain of the cyanuret. Chaussier1 and Parent. St. Hydrarg. cyanuret. 9ss. Solve in Aq. distillat. ftj. Adde Tinctura? opii, £j. M. Dose.—Morning and evening, a spoonful, in a decoction of sar- saparilla or barley. Mendoza and Parent. 1 Rattier, Formulaire Pratique des H6pitaux civils de Paris, 3eme edit. Paris, 1827. 264 NEW REMEDIES. Pilula Hydrargyri Cyanureti. Pills of Cyanide of Mercury. St. Hydrarg. cyanuret. gr. v. Opii puri, Qss. Micae panis, gj. Mellis, q. s. ut riant pilulae xcvj. Dose.—One to four, three times a day. Parent. Gargarisma Hydrargyri Cyanureti. Gargle of Cyanide of Mercury. St. Hydrarg. cyanuret. 9ss. Decoct, len. sem. lini, (vel rad. althaeae), ftj. M. et fiat gargarisma. Parent. 5<. Hydrarg. cyanur. Qss. Decoct, hordei, ibj. Mellis rosati, 3j. M. et fiat gargarisma. Brera. Unguentum Hydrargyri Cyanureti. Ointment of Cyanide of Mercury. St. Hydrarg. cyanur. gr. xij. Adipis, 3j. M. et fiat unguentum. Brera. 5<. Hydrarg. cyanuret. gr. xvj. Adipis, gj. 01. limonis, gtt. xv. M. From half a dram to a dram, to be rubbed in, in cases of tetter. Biett. hydrargyri proto-ioduretum. 265 III. HYDRARGYRI PROTO-IODURETUM. Synonymes.—Hydrargyrum Iodatum flavum, H. lodidum, H. Iodidulatum, H. Iodatum (in contradistinction to the Periodatum), lodidum Hydrar- gyrosum, Hydrargyri Proto-iodidum, Proto-iodide or Proto-ioduret of Mercury. French.—Proto-iodure de Mercure. German.—Gelbes Iodquecksilber, Gelbes Q,uecksilberiodid, Protoiodiir des Q,uecksilbers, Q,uecksilberiodidul, Iodquecksilber im Minimum des Iods. method op preparing. According to Tunnermann, the best method of preparing the Proto-ioduret is the following :—Take of the nitrate of protoxide of mercury, (not tinged yellow by the admixture of the nitrate of peroxide) 28.25 parts, and 16.5 parts of iodide of potassium; rub them together for some minutes in the dry state, and afterwards with a little distilled water, gradually adding the water so as to dissolve the saltpetre formed. The mixture is then passed through the filter, and the yellowish green precipitate of iodide of mercury is well washed, and then dried by a gentle heat. The objection to this process is the difficulty of obtaining the mercurial salt at a minimum of oxidation, and the consequent lia- bility of the resulting compound to contain uncertain quantities of the deuto-iodide. M. Boutigny1 to avoid these disadvantages re- commends the following form. St. Hydrarg. proto-clilorid. 3iij & gv. Potassii iodidi, 3ij & £iv. Pulverise the iodide in a glass mortar, and add the calomel; place the mixture in a porcelain capsule, and pour over it ten or twelve ounces of boiling distilled water. After cooling, decant the fluid, collect the precipitate on a filter, and wash with distilled water. Dry in the shade and keep in a well-stopped bottle. The proto-iodide, thus prepared, may, according to M. Boutigny, sometimes contain a minute portion of mercury or its protochloride, but the quantity of either is so small as to be of no moment. In the new London Pharmacopoeia, it is prepared by rubbing to- gether an ounce of mercury and five drams of iodine, adding gradu- 1 Bulletin General de Therapeutique, and American Journ. of Pharmacy, 2d vol. 2d series, p. 326. Philad. 1837. 34 266 NEW REMEDIES. ally as much alcohol as may be sufficient until globules are no longer visible. The powder is dried immediately by a gentle heat, access of light being excluded, and it is kept in a well stopped vessel.1 The proto-iodide, according to Thomson, consists of 250 parts of mercury, and 156 parts of iodine. It has a greenish yellow colour, and is a preparation holding the same relation to iodine and mer- cury, that calomel holds to chlorine and mercury ; it is more vola- tile, however, than calomel, but like it is almost insoluble in water. EFFECTS ON THE ECONOMY. This preparation has been less used than the deuto-ioduret, to be described next. Tunnermann remarks, as the results of his experience, that its action in respect to the mercury, is analogous to that of calomel, except that it appears to excite more the lympha- tic and glandular systems. When given in conjunction with a generous animal diet, he found it very efficacious in a case of scro- fulosis, where colliquative sweats had appeared; and in a second case, also, it rendered essential service. In one of the cases, he gave it internally in the dose of from one twelfth to one half a grain three times a day ; in the other of from one half a grain to a grain. He directed it also to be rubbed, in the form of ointment, on the tumefied glands of the neck. Pelletan likewise found it serviceable in the cure of obstinate glandular swellings, when used in the form of ointment in combination with morphine, as well as in cases of obstruction of the liver. Biett recommends an ointment of the protoioduret in the treatment of chronic venereal ulcers, the cica- trisation of which it expedites; Lugol2 advises it in phagedenic scrofulous ulcers, which present a syphilitic aspect; and Poiret3 re- commends it strongly in cases of psoriasis; the patient using at the same time simple alkaline or vapor baths alternately. According to the experience of Ricord,4 in the syphilitic affections of children, especially of a cutaneous character, it is to be preferred to other forms of mercurial, and is not apt to be followed by the bad effects, which in adults, often supervene on the use of other preparations.5 1 Brande, Dictionary of Materia Medica, p. 289. Lond. 1839. 2 Essays on the effects of Iodine in scrofulous diseases, &c. by Dr. O'Shaughnessy, p. 170. Lond. 1831. 3 Gazette des H6pitaux, Juillet 20, 1837; see, also, Bulletin General de Therapeutique, Juillet, 1837. * La Lancette Francaise, No. 65., 1834. 6 Cogswell's Essay on Iodine, p. 158. Edinb. 1837. HYDRARGYRI PROTO-IODURETTJM. 267 METHOD OF ADMINISTERING. On account of its insolubility, it is given only in the form of powder or pill, to the extent of from one-twelfth to half a grain, twice or thrice a day. Externally, it is applied, for the same rea- sons, in the form of ointment only. Pilula Hydrargyri Iodidi.—(Pharmac. Londin.) Pills of the Iodide of Mercury. St. Hydrarg. iodidi, £j. Confect. rosse caninffi, ^iij. Zingiberis contritae, £j. M. Pilula Hydrargyri Proto-Iodureti Composita. Compound Pills of Proto-iodide of Mercury. St. Hydrarg. proto-iodur. gr. vj. Extract, opii, gr. iv. Lactucarii, gr. xxiv. Ext. guaiac. gr. xlviij. M. Fiant pilulae xlviij. Dose.—For a child, half a year old, one pill ; for older children, two, three, or four. In the syphilis of children. Ricord. St. Hydrarg. protc-iodur. gr. j. Ext. junip. gr. xij. Pulv. glycyrrhiz. q. s. Divide in pulv. viij. Dose.—At first, two, morning and evening; afterwards, three or four. Magendie and Biett. Pulveres Hydrargyri Proto-lodureti. Powders of the Proto-iodide of Mercury. St. Hydrarg. proto-iodur. gr. i, (iv, vj, vel viij.) Magoes. alb. 3j. M. Et divide in part. xij. Dose.—A powder three times a day. Unguentum Hydrargyri Proto-Iodureti. Ointment of the Proto-iodide of Mercury. St. Hydrarg. proto-iodur. gr. vj. Morphin. acetat. gr. viij. Adipis, 3j. M. Iii obstinate glandular swellings. Pelletan. 268 NEW remedies. St. Hydrarg. proto-iodur. 9j. Adipis, §iss.' M. In old venereal ulcers. Magendie and Biett. St. Hydrarg. proto-iodur. Bij. (vel iij, vel rv.) Adipis, gij. M. As a dressing to phagedenic and scrofulous ulcers. Lugol. When this salve is first prepared, it is of a canary yellow, some- times of a greenish, colour. By time, it becomes of an orange hue, when it must be thrown aside, as, owing to the formation of the deuto-ioduret, it has become as corrosive as the ointment of cor- rosive sublimate. St. Hydrarg. proto-iodureti, 3J. Adipis, gj. M. To be rubbed morning and evening on the parts affected. Poiret. Unguentum Hydrargyri Iodidi—{Lond. Pharm.) Ointment of Iodide of Mercury. St. Hydrargyr. iodid. 3j. Cerse alba5, ^ij. Adipis, 5vj. M. IV. HYDRARGYRI DEUTO-IODURETUM. Synonymes.—Hydrargyrum Iodatum Rubrum, H. Biniodidum, H. Perioda- tum, lodidum Hydrargyricum, Deutoiodide of Mercury, Biniodide of Mereury. French.— Deuto-Iodide de Mercure, Periodure de Mercure. Germ an.—Rothes Iodquecksilber, Iodquecksilver im Maximum, Quecksil- beriodid, Deuto-Iodur des Q,uecksilbers. METHOD OF PREPARING. According to Tunnermann, this beautiful preparation may be obtained by double decomposition, by mixing 137 parts of corrosive sublimate with 165 parts of iodide of potassium, rubbing them together, for a time, in the dry state, and afterwards with water, to dissolve the chloride of potassium formed. To prevent a solution 1 Tunnermann uses only §ss. HYDRARGYRI DEUTO-IODTJRETUM. 269 of the precipitate in this salt, the mixture is put into a glass vessel, and agitated with a considerable quantity of water, until the super- natant liquid appears entirely clear, for which purpose a few minutes suffice. It is now filtered; the residue on the filter well washed, and gradually dried by warm air. By this process, the potassium unites with the chlorine of the mercury, and the mer- cury with the iodine in the dry way; the water is only useful in removing the chloride of potassium. The following is the process recommended in the London Phar- macopoeia :—An ounce of mercury and ten drams of iodine are to be rubbed together, alcohol being gradually added until the glo- bules are no longer visible. The powder is to be dried with a gentle heat, and kept in a well-stopped vessel. The deuto-ioduret of mercury is a beautiful vermilion-coloured powder, which, when moderately heated, becomes yellow, but, when exposed to the air, is gradually restored to red, and is volatilised. When volatilised, it crystallises in beautiful rhomboidal leaves, which, at a higher temperature, are of a golden yellow hue; but at the ordinary temperature of a shining red. The deuto-iodide is insoluble in water; but soluble in alcohol and ether. It contains 250 parts of mercury, and 312 of iodine. EFFECTS ON THE ECONOMY. This preparation, which was introduced into practice by the French physicians, has been particularly recommended in syphilis complicated with scrofula. Biett found it very efficacious in scro- fulo-venereal ulcers, in syphilitic swellings of the lymphatic glands, and in inveterate itch. He administered it also internally, dis- solved in alcohol or ether, in scrofulous affections complicated with syphilis, and with advantage. In its effects, it resembles the cor- rosive sublimate, whilst the proto-ioduret resembles calomel. Rayer,1 indeed, considers the deuto-iodide more active than the corrosive sublimate. Paillard found it very efficacious in chronic cutaneous eruptions. He dipped a camel's hair pencil in a weak solution of the deuto-ioduret in ether, and penciled the parts with it three or four times a day. In this way, he cured several squa- mous, tuberculous, and other eruptions, exciting scarcely any pain. As, however, this mode of applying it often failed, he employed 3j ' Treatise on Skin Diseases, by Dr. Willis, p. 79. See, also, Puche, Journal des Connaissances Medicales, Oct. et Nov. 1838, & Janvier, 1839. 270 NEW REMEDIES. mixed with gj of oil of almonds in the same manner. If the cor- rosive action was considerable, a sense of heat soon arose in the part, which gradually terminated in burning pain. The neigh- bouring parts were also hot, painful, and tumefied ; and, in the course of an hour, an effusion of serum took place ; but, in four or five hours, the pain always disappeared. If applied on the cheeks or lips, salivation at times ensued suddenly. Scabs formed, which fell off in a few days, and exposed a red surface, much disposed to cicatrise. When frequently applied, symptoms oc- curred, which were probably the consequences of its being ab- sorbed, namely, fever, colic, diarrhoea, and dysentery. Breschet1 applied it, in the form of ointment, with great success, in a case of obstinate ulceration, presumed to be carcinomatous, at the angle of the eye. Blasius recommends it internally and externally in lupus. Tiinnermann used it with advantage, in the form of ointment, for the removal of furuncular inflammation of the glands of the neck. Riecke,2 likewise, employed it as a discutient, (gr. xvj to gj of lard,) in a case of ganglion in the region of the knee—whence vio- lent pain proceeded along the nerves when it was pressed upon— and in two cases of goitre, with great success. Whenever it has to be applied over an extensive surface, as in the disease last men- tioned, it has generally to be discontinued soon, in consequence of the supervention of inflammation of the cutaneous surface. In the form of a weak ointment—composed of the deuto-iodide gr. ij, cerate 9ij, almond oil 9j—it has been used in opacity of the cornea.3 Recently, Kopp has published some favourable cases of the the- rapeutical application of the deuto-ioduret. The ointment, given below, he found very efficacious in luxuriant, chronic, scrofulous, and syphilitic sores, as well as in condylomata, and venereal blotches. Not less useful did he find it in many other skin dis- eases, and particularly in herpes. In one case, in which he ad- ministered it in the last affection, he found a coexistent goitre, which had been there for several years, almost wholly disappear; and he, consequently, afterwards prescribed it frequently for the latter affection. He also used it, with excellent effect, in ophthal- mia tarsi, and, where there was a disposition to the formation of 1 Lugol's Essays on Iodine, hy O'Shaughnessy, p. 204. 2 Die neuern Arzneimittel, u. s. w. S. 270. 3 Grafe und Walther's Journ. fur Chirurg. Bd. xiii, cited by Pereira, Ele- ments of Materia Medica, pt. i, p. 483. Lond. 1839. HYDRARGYRI DEUTO-IODURETUM. 271 hordeolum, a little of the second ointment, given hereafter, was ap- plied at bed time to the edges of the eyelids. Lastly, he advises friction with the first ointment in chronic rheumatic pains, and in cases of induration of the glands, especially of the liver. After the friction has been continued for some time, an eruption occasionally appears. We have frequently administered the deuto-ioduret in public and in private practice, in cases where an active sorbefacient appeared to be needed, and where a combination of remedies so potent as mercury and iodine suggested itself. In chronic glandular en- largements, especially of the liver and spleen, and in habits where the use of mercury was not contra-indicated, both the deuto-ioduret and the proto-ioduret have, in our hands, proved extremely ser- viceable. Perhaps there are no preparations belonging to the class of sorbefacients, which, under the circumstances in question merit more attention. MODE OF ADMINISTERING. The deuto-ioduret of mercury is given internally in the form of powder or pill, or dissolved in alcohol or ether, in the dose of one sixteenth to one fourth of a grain daily. Externally, it is applied in the form of ointment. Pilula Hydrargyri Deuto-Iodureti. Pills of the Deuto-ioduret of Mercury. St. Hydrarg. deuto-iodur. in syrup, comraun. pauxill. terendo bene distribuend. gr. v. Micae panis alb. Pulv. sacch. alb. aa. q. s. ut fiant pilulse lx. Dose.—Two, morning and evening, drinking afterwards a cup- ful of oatmeal gruel. The dose to be raised gradually. Blasius. Tinctura Hydrargyri Deuto-Iodureti. Tincture of Deuto-ioduret of Mercury. !v. Hydrarg. deuto-iodur. 9j. Alcohol 36° (.837) |iss. M. Dose.—Ten to twenty drops in a glass of distilled water. Magendie and Biett. 272 NEW REMEDIES. JEther Sulphuricus cum Hydrargyri Deuto-iodur eto. Sulphuric Ether with Deuto-ioduret of Mercury. 5*. Hydrarg. deuto-iodur. 3j. iEther. sulphur. ,§iss. M. Administered like the last. Magendie and Biett. Unguentum Hydrargyri Deuto-Iodureti. Ointment of Deuto-ioduret of Mercury. 3*. Hydrarg. deuto-iodur. subtiliss. trit. gr. vj. Adipis, 3vj. M. Kopp. St. Hydrargyr. deuto-iodur. subtiliss. pulv. gr. § to \. Adipis, 9ij. Cerae albse, gr. ij. M. fiat unguentum. For an eye salve. Kopp. St. Hydrargyri deuto-iodur. gr. xv. Adipis, ^ss. M. exactissime. Fiat ung. As a dressing in lupus. Blasius. St. Hydrarg. deuto-iodur. gr. xv. Adipis, ^ij. 01. bergamot. gtt. x. M. To be rubbed on the parts in chronic cutaneous affections. Biett. St. Hydrarg. deuto-iodur. 9j. Adipis, §iss. M. To be spread thin on lint in old venereal ulcerations. Biett. INDIGUM. 273 INDIGUM. Synonymes—Indicum, Indicus Color, Pigmentum Indicum, Indigo. German.—Indig. , This well-known colouring material is obtained from several species of the genus Indigofera, (I. tinctoria, I. anil, I. disperma, I. argentea, and I. hirsuta,) belonging to the natural family Legu- minosae, and, in the Linnaean system, to the class Diadelphia, order Decandria. As we receive it, it is in small, solid, brittle masses, of a deep azure colour, without smell or taste, and assuming a coppery lustre on being rubbed. It is entirely soluble in sulphuric acid, and is wholly consumed on burning coals. According to the analysis of Chevreul, 100 parts of the Guatemala indigo of com- merce contain only 45 parts of pure indigo, or indigo-blue—with which no therapeutical experiments have as yet been made ; the greater part of the residue consists of a green matter soluble in spirit of wine, (indigo-green;) and a red resin, (indigo-red;) the rest is extractive matter, gum, and some carbonate of lime, oxide of iron, argillaceous and siliceous earth. With hydrogen, pure indigo forms isatic acid, which has considerable resemblance to the hydrocyanic. EFFECTS ON THE ECONOMY. * The natives of the countries where the different kinds of indigo grow, employ it occasionally as a therapeutical agent, especially in diarrhoea and intermittent fever. It is only within the last few years that attention has been paid to it in Europe. Professor Von Stallly,1 of Ofen, appears to have first employed it with success in various spasmodic diseases, especially in epilepsy. To these cases Lenhossek alludes, in detailing certain trials which he himself had made with it. In 1833, Grossheim2 made known a case, in which he found it extremely useful. A lady, twenty-eight years of age, had suffered for eleven years with violent hysterical convulsive attacks, for which she had employed almost every remedial agent. The attacks began with a feeling of heaviness over the whole body, with slight convulsive twitchings of the limbs, which extended to 1 Hecker's neue Annalen, B. i, H. 1. Berlin, 1835. * Mediscinische Zeitung, No. 51, 1833. 35 274 NEW REMEDIES. the trunk, and were followed by total, or almost total, loss of con- sciousness : this, after an uncertain period, terminated in a coma- tose state, from which she was gradually restored—but in a languid condition—to perfect consciousness. Under the use of indigo for half a year, with pediluvia, which had been previously employed without advantage, she completely recovered. These results gave occasion to the institution of experiments, touching the remedial properties of indigo, in the Charite at Berlin, the results of which have been given by Roth.1 In most of the cases, the indigo excited nausea, and even vomiting, preceded by a metallic taste on the tongue. At times, the vomiting was so violent and prolonged, that it was necessary to discontinue it; but gene- rally, on continuing the use of the indigo, the vomiting ceased in three or four days, and diarrhoea took its place. All the patients did not vomit, and many escaped the diarrhoea. When once diarrhoea occurred, however, it commonly persisted so long as the indigo was used. The evacuations were seldom entirely fluid, but usually semifluid, and of a dark bluish-black colour. While the vomiting and purging continued, more or less uneasiness was ex- perienced in the digestive apparatus. The vomiting and diarrhoea were frequently accompanied by pains in the stomach and bowels, which were commonly mild, but occasionally so violent that the indigo had to be discontinued. In every patient at the Charite, the urine was of a dark violet hue. Stahly affirmed, that the perspira- tion was coloured blue, but this Roth never observed. He re- marked, moreover, that after the use of indigo for several weeks, certain patients were easily thrown into slight convulsions, similar to those caused by the use of the nitrate of strychnine, and that they were affected with slight subsultus tendinum. Almost all the patients, indeed, who took indigo, were at first more frequently attacked with spasms than prior to the use of the remedy. In the beginning, the attacks of the disease were, in all cases, stronger, but of less duration, than previous to its employment. These changes continued for one, two, three, and even as long as eight weeks, whether the patients took small or large doses of indigo. At the expiration of this time, all the epileptic symptoms were diminished in intensity and duration, until the last attacks were mere premonitions. The number of epileptic cases, treated by indigo, which Roth had an opportunity of observing in the Charite, was twenty-six ; of 1 Hecker's neue Annalen, B. i, Heft. 1. Berlin, 1835. INDIGUM. 275 these, nine were cured, eleven improved, and six remained un- cured. Dr. Ideler,1 who instituted the experiments at the Charite, has also given publicity to the results ; and his testimony accords with that of Roth. It is proper to observe, however, that of the nine cases cured, three experienced relapses in from eight to twelve months ; but from causes, according to Riecke,2 which, of them- selves, might have induced epilepsy. Dr. Strahl,3 of Berlin, likewise experimented with the indigo, but his results were by no means favourable. In ten cases of old standing epilepsy, the indigo was not of the slightest service, and the same may be said of two cases of St. Vitus's dance. In four cases of hysteria, it excited violent nephralgia, and in one of the cases only, after the affection of the kidney was removed, was the patient cured. The indigo acted, however, signally on the uterus; in two cases of spasmodic affections complicated with amenorrhoea, the latter derangement was removed, whilst the spasms, even after the recurrence of the catamenia, still continued. In the Charite of Berlin, the purest Guatemala indigo of commerce was used, and it may be a question, whether Strahl did not employ one of feebler powers. It is worthy of remark, that he observed a dark green colour of the urine during its use, whilst in the cases in the Charite, a dark violet hue was constantly noticed. Favourable cases are also detailed by Drs. Mankiewicz, of Nackel,4 and Hohnhorst, of Frankfort.5 Dr. Noble, of Versailles.6 administered it in three cases, in which the disease had continued for four, twelve, and twenty years re- spectively. At the time of making known the results, a month had elapsed in the first case, and two months in the second, since an attack had been experienced, and the last case he considered en- tirely cured. In the first patient, who was eighteen years old, four drams occasioned vertigo, slight depravation of vision, and convul- sions similar to those produced by strychnine ; and in both the other cases, diarrhoea was induced, which ceased, however, as soon as the indigo was discontinued or the dose reduced one half. He 1 Medicinische Zeitung, No. vi. and Lancet, June 6, 1835. 2 Op. cit. S. 276. 3 Hecker's Neue wissenschaftliche Annalen, 1836; and Edinb. Med. and Surg. Journal, 1837. * Medicin. Zeitung. Mai 31, 1837, S. 109. s Ibid. S. 110. 6 Bulletin General de Therapeutique, 1836. 276 NEW REMEDIES. gave it in the dose of one dram gradually increased to four drams daily. The observations of Rech, of Montpellier, were not as favourable to the indigo. In none of the epileptics to whom he gave it was there any thing more than a slight amelioration. In the Hospice d'Hommes Incurables du Faubourg St. Martin, trials were also made with it by Dr. Blanche. Often cases five were either cured or improved. One of these had existed for three years, and the paroxysms recurred every five or six days; but after the administra- tion of the indigo, he had no return at the expiration of five months ; in a second case, a youth fifteen years old—who had been epileptic from birth, and had regularly one or two paroxysms a day, from the 19th of July, when the exhibition of the indigo was begun with, until the middle of August, when the results were published—had only two insignificant attacks. The improvement in the other three cases was not as marked, yet it was unquestionable. The other five children experienced no improvement, yet no inconve- nience was sustained, although the indigo was given in doses of four, six, and eight drams in the day. It was administered in wa- ter or in a tisane; and in one or two cases it excited vomiting, but after having been discontinued, it was borne subsequently. In all it induced tormina, and acted upon the bowels, but did not interfere with the appetite or any of the other functions. Very recently, Dr. Benjamin F. Hardy,1 one of the senior resident physicians at the Philadelphia Hospital, has published the results of some trials made with the indigo, which, so far as they go, con- firm its antiparoxysmal power. Two of the seven cases reported were apparently cured, two ameliorated, and three without any de- cisive results—the medicine not having been continued perhaps for a sufficient length of time. In these cases, the indigo was com- menced in the dose of 3j, which was usually doubled daily until the patient took giji daily, which quantity was persevered in for some weeks. In some of the cases the faeces, urine, and perspira- tion were all coloured blue. In other trials, instituted in the same excellent charity, with the indigo, the*results were not as favourable. It is obvious indeed, that a wide difference must exist amongst cases of epilepsy, and that where the organic modifications are considerable, as indi- cated by concomitant mania or idiocy, but little can be expected from any remedy; but even in such hopeless cases, the number of 1 Americau Medical Intelligencer, for July 15, 1839, p. 122. INDIGUM. 277 paroxysms appears to have diminished under its use. Where the cerebral affection is slight and more functional than organic, the indigo, like the artemisia and other remedies extolled in epilepsy, may be useful. Its main efficacy, perhaps—as we have said of the Ferrum Carbonatum Praecipitatum (p. 208)—consists in the new impression which it makes, in adequate doses, upon the nerves of the stomach, and through them upon those of the whole system; but to effect the revulsion to the proper extent, it is necessary that the dose should be augmented day by day, and the remedy be con- tinued in large doses for a sufficient length of time. MODE OF ADMINISTERING. As the indigo is extremely light, the powder is too bulky for ad- ministration ; it is taken with disgust, and is apt to excite vomiting. On this account, the form of electuary was selected in the Charite. It was generally combined with the pulvis aromaticus, or the pulvis Doveri. As to the dose, Roth advises, that it should be commenced in grains but be elevated to drams, nay even to one or more ounces in the day. In the Charite the following formulas were generally employed:— Pulvis Indigi. Powder of Indigo. 8<. Indig. subtilissim. pulver. gss. Pulv. aroraat. gr. v. M. et fiat pulvis. A powder to be given four times a day. Electuarium Indigi. Electuary of Indigo. St. Indig. pulv. aquae guttis nonnullis subact. ^ss. Pulv. arornat. £ss. Syr. sirapl. |j. M. et fiat electuarium. To be used in the course of the day. Ideler. 278 NEW remedies. IODINUM. Synonymes.—Iodinium, Iodium, Iodum, Iodina, Iodine. French.—lode. German.—Iod. Iodine was accidentally discovered, in the year 1812, by Courtois, a manufacturer of saltpetre at Paris, but it was chiefly through the labours of Gay-Lussac and Sir Humphry Davy,1 that the chemical relations of this elementary body were appreciated. The discoverer first detected it in the mother waters of soda obtained from sea-weed ; and as it was found to exist chiefly in" several of the sea-weeds, and especially in the sponges, it struck Coindet,2 that experiments might be made with it in goitre ; from these he obtained such valuable results that its reputation soon spread abroad, and it was employed in various other diseases,—often with the most marked advantage. By experience, too, the injurious effects which it is generally considered capable of inducing were appreciated, so that it could be administered more satisfactorily than at an earlier period. By the continued investigations of the chemist, iodine was found to be more largely distributed than was at first imagined. It was discovered in many of the marine mollusca, in sea-water, and in several mineral waters. METHOD OF PREPARING. Iodine is obtained from the mother waters of the soda derived from sea-plants, in which it exists in the form of hydriodate of potassa. The waters are procured by burning different kinds of weeds which grow on the sea-shore, lixiviating the ashes, and con- centrating the liquor. To obtain the iodine from this liquor, an excess of concentrated sulphuric acid is added to it, and the whole is boiled gently in a glass retort furnished with a receiver. The sulphuric acid lays hold of the basis of the hydriodic salt, and of the hydrogen of the hydriodic acid ; whence result sulphate of potassa, water, sulphurous acid and iodine; the last passing over into the 1 Annales de Chimie, lxxxviii. xc. and torn. xci. and Philos. Transact. 1814 and 1815. *Bibliotheque Universelle, Juillet, 1820, p. 190. IODINUM. 279 receiver in violet fumes with a little acid, and there becoming con- densed. To purify the iodine, it may be washed with water, con- taining a little potassa, and be redistilled.1 Iodine is solid at the ordinary temperature, of a foliated appear- ance, metallic lustre ; of a grayish black colour similar to that of plumbago, and friable. Its taste is hot, notwithstanding its sparing solubility in water. It is soluble in 7000 parts of that fluid, and the solution has an orange yellow colour. Its specific gravity is 4.946 at 62° of Fahrenheit. Its smell is similar to that of chlorine, with which it accords in its property of destroying vegetable colours. It possesses, in a high degree, electro-negative properties. It colours the skin yellow, which colour gradually disappears. It fuses at 220° Fahrenheit. The vapour is of a beautiful violet colour, whence its name (*«$»?, 'blue'). It is soluble in ether and in alcohol ; forms an acid both with oxygen and hydrogen, and enters into numerous chemical combinations.2 EFFECTS ON THE ECONOMY IN HEALTH. Soon after the discovery of iodine, and the accurate investiga- tions of Gay-Liissac, Magendie3 instituted a series of experiments in order to appreciate its action on the animal organism. It was injected into the veins without any apparent effect. Several dogs were made to swallow it; they vomited, but it exerted no farther effect. He himself swallowed a coffee-spoonful of the tincture, and perceived no other result than a disagreeable taste, which continued for several hours, but gradually disappeared. In larger doses, how- ever, the effects were markedly injurious. Orfila4 likewise instituted several experiments on dogs, from which he concludes:—that iodine, introduced into the stomach in moderate quantity, acts as a gentle stimulant, but may excite vomiting:—that in the dose of a dram, it almost always killed the animal in four or five days, when the oesophagus had been tied to prevent vomiting, and that in the part of the mucous membrane with which it came in contact, ulcers were gradually formed :—that when administered in the dose of from two to three drams, when the oesophagus was not tied, it 1 For the method employed by Soubeiran, see Journal de Pharmacie, Janvier, 1837; and for that by Barruel, see Bussy, Ibid. 2 See, on Iodine and its combinations, Mr. Duhamel, in Philad. Journal of Pharmacy, vi. 101. Philad. 1823--4. 8 Formulaire pour la preparation, &c. de plusieurs nouveaux Medicamens. 4 Toxicologic, i. 556. 280 NEW REMEDIES. excited vomiting for several hours, even when a part of the poison had been evacuated by the bowels;—that it seldom caused death when given in the dose of one or two drams, the animal rejecting it by repeated vomiting ; that it does not destroy life when applied externally, and that it must be classed amongst the irritant poisons. Dr. Cogswell,1 in repeating one of Orfila's experiments, in which seventy-two grains of iodine were introduced into a wound on the back of a dog without much effect on the health of the animal, did not attain exactly the same results. He introduced a scruple of iodine into the cellular tissue of the thigh of an adult rabbit, through a small opening made in the skin. The animal manifested no symptom of pain, and was able to make use of the limb as freely as before the operation, but, in the course of a fortnight, it gradually lost flesh, exhibiting an emaciated look, and the hair dropped off from many parts of the head. At the end of this time, thick adhesive pus was found distending the cavity of the wound, from which the iodine had entirely disappeared. Dr. Cogswell properly suggests, however, the possibility, that the irritation of a large abscess might have been the sole origin of the animal's unhealthy appearance. To discover the effects, which it induces on man, Orfila took two grains fasting. An extremely disagreeable taste, with some nausea, was the only consequence. On the next day, early, he took four grains, when he immediately experienced a sense of constriction and heat in the throat, which continued for a quarter of an hour; soon afterwards he vomited a liquid yellowish matter, in which iodine was easily perceptible. Except a slight degree of oppression felt during the day, he observed no change in any of the functions. On the second day thereafter, he took six grains fasting, after which, he soon experienced a sense of heat, constriction of the throat, nausea, eructation, increased flow of saliva, and pain at the pit of the stomach ; ten minutes afterwards, he was attacked with copious bilious vomiting, and slight colic pains, which continued for an hour, and were removed by two emollient glysters. The pulse which, prior to the experiments, beat sixty times in the minute, became more frequent, beating from eighty-three to ninety, and was much stronger. The breathing was tolerably free; but from time to time, there appeared to be a great obstacle to the dilatation of the chest on inspiration. The urine was higher 1 Experimental Essay on Iodine and its compounds. By C. Cogswell, A. B., M. D. p. 21. Edinb. 1837. I0DINUM. 281 coloured. All the symptoms were removed by the copious use of gum water as drink, and of emollient glysters. Dr. Gully says, that he has given as much as three drams of the tincture daily, and did not observe any effect. Dr. Kennedy,1 of Glasgow, exhibited, within eighty days, nine hundred and fifty- three grains of iodine in the form of tincture, the doses having been so proportioned, that, towards the last, the patient—a girl— did not seem to be in any way particularly affected. Dr. Buchanan2 has given half an ounce of the iodide of potas- sium within twelve hours, without any unpleasant result, provided diluents were largely taken at the same time. It has been con- ceived, that where iodine proves mischievous, it is owing to its being in a free state, and that it then operates as a corrosive poison. The tincture of iodine, and the ioduretted hydriodates, are esteemed to be objectionable on this account.3 From experiments, instituted by Jorg4 on himself and on other healthy individuals, it appeared to him, that iodine, first of all, acts as a stimulant on the intestinal canal ; soon afterwards, it excites, also, the different glands in the cavity of the mouth and stomach, the pancreas, the liver, and even the urinary and genital organs. An afflux of blood to the respiratory organs likewise ensues, which extends even as far as the Schneiderian membrane. There is no doubt whatever that the iodine enters into the blood, and, in this way, doubtless produces its modifications on the system of nutrition. Two drams, according to Dr. Buchanan,5 were given to a young man labouring under gonorrhoea, and, as soon as the medicine made its appearance in the urine, blood was drawn from the arm. On examining it, both the serum and the crassamentum were found deeply impregnated with iodine. The same dose was given to a boy affected with dropsy of the knee-joint. About five hours after the dose had been taken, a very small puncture was made into the joint, and upwards of twelve ounces of synovia were drawn off by a cupping-glass. The synovia contained iodine in abundance. To an old man, who had a very large hydrocele, two drams of iodide of potassium were given over night, and the same quantity the following morning: on tapping him some hours after 1 Lond. Med. Repository for 1822. 2 Lond. Med. Gazette, July, 1836. See, also, Fuster, in Bullet. General de Therap. Fev. 1S37, & Sep. 1837. 'Brande's Dictionary of the Materia Medica, p. 323. Lond. 1839. 4 Materialen zu einer kiinft. Heilmittellehre, u. s. w. i. 473. 1824. 8 Op. cit. 36 282 NEW REMEDIES. he had taken the last dose, mdre than thirty ounces of serum were drawn off, containing a large quantity of iodine.1 Dr. Gairdner2 observed the action of iodine on the human body when administered in particular doses, and pointed out the dis- advantages attendant upon an improvident use of the article. The most striking inconveniences were induced in the digestive organs: it excited diarrhoea, and, at times, obstinate constipation; gastro- dynia and violent vomiting, especially when food was received fnto the stomach. The emaciation occasioned by it, is, according to some, a striking phenomenon; and may attain an incredible extent; yet it is proper to remark, that Lugol.3 in his frequent employment of iodine in scrofula, never observed this result: he affirms, indeed, that emaciated patients became stronger under its use; that the stout did not grow leaner, and that they who held the medium po- sition, in these respects, acquired strength under its employment,— results which have been confirmed by others, and which would, therefore, seem to show that this, as well as some of the other un- pleasant effects ascribed to iodine, may have been owing to an in- cautious use of the article. In addition to the above effects, Gairdner noticed anxiety, de- pression of spirits, and other symptoms similar to those of hypo- chondriasis; obscurity of vision; hardness of hearing; palpitations; and tremors of the limbs, particularly of the hands, which last symptom indicated the full effect of iodine on the constitution. Dr. Gairdner found, however, that the remedy was extremely vari- able in its effects; and that it might frequently be given in large doses, for a long time, without disadvantage, whilst, at other times, the unpleasant symptoms supervened rapidly; indicating that much must depend upon the peculiar impressibility of the indi- vidual. Coindet,4 who, as we have remarked, first used the iodine as a therapeutical agent, speaks of many of the above-mentioned phe- nomena as resulting from the administration of iodine; these he considers evidences of the saturation of the organism, as the effect 1 Brande, Op. citat. p. 321, Lond. 1839. See, also, M. Cantu, in Journal de Chimie Medicale, ii. 291 & 394 ; and Bennerscheidt, Ibid. iv. 383. 2 Essay on the Effects of Iodine, &c. Lond. 1824. 3 Memoire sur l'emploi de l'lode dans les Maladies scrofuleuses. \ Paris, 1829; and Observations on the Effects of Iodine, p. 17, Johnson's trans- lation. Lond. 1824. 4 Bibliotheque universelle, Mars, Avril, Mai, et Septembre, 1821. IODINUM. 283 on the mouth is an index of the same thing in the case of mer- cury. It appears, however, to be never necessary, in the admi- nistration of iodine, to induce a saturation of the organism in order that the full sanative influence of the remedy shall be elicited. On the contrary, it seems to be advisable to avoid such saturation; and, accordingly, whenever there are the slightest indications of it, the dose of the iodine should be diminished, or it should be dis- continued for a time; after which—according to the results of numerous cases—its curative agency, when it is resumed, is ex- erted afresh, and more decidedly. Several physicians, indeed, advise that frequent intermissions should be made in the use of the agent, in order that its action may be more certain. According to the observations of Coindet and Formey, iodine, when administered internally, occasions increase of appetite; but no influence is perceptible on the condition of the bowels and uri- nary organs; or on the perspiratory apparatus. On the other hand, when breathed for a few instants, the vapours of iodine twice caused in M. Chevallier1 violent colic, which readily yielded to gum water and laudanum. Raspail, however, under analogous circumstances, experienced no other inconvenience than a disagree- able taste in the back part of the mouth. According to Lugol, the vapour disengaged from tincture of iodine poured into the water of a bath, is liable to induce a state of " iodic intoxication," and even of cerebral congestion. He affirms, that it exerted a power- ful diuretic influence on all his patients, the urinary secretion being so much augmented, that many of them, contrary to their usual habit, were compelled to rise from bed several times in the night to discharge their urine. In upwards of a third it had a cathartic effect, producing six or seven evacuations in the day, and occasionally tormina. In several, ptyalism ensued. Others, and especially females, complained of gastrodynia, which was always removed by the wine of cinchona, of which two or three ounces were taken shortly after the iodine. Dr. Manson,2 who used the tincture of iodine, occasionally found it produce sickness of stomach, and Mr. Delisser affirms, that, in two months, he gave one thousand and nineteen grains of iodine to a female affected with cancer of the mamma,—the doses, at cer- tain periods, amounting to thirty grains in the twenty-four hours. The consequences were anorexia, quick pulse, ulceration of the 1 Journ. General de Med. ciii. 336. 2 Medical Researches on the Effects of Iodine. Lond. 1825. 284 NEW REMEDIES. mouth, and foetor of the breath, of a different kind, however, from that which arises from mercury. It would appear, that the effects of the remedy vary according to the form in which it is administered, and it is proper to observe, in viewing the different results obtained by Lugol and Coindet, that the latter commonly gave the tincture of iodine, whilst the former prescribed the solution in water, with a little muriate of soda. Lugol also observes, that the appetite of his patients was very much increased by it. Eager, who likewise administered the watery solution, but rarely observed diarrhoea and emaciation ; and, in general, indeed, the appetite and nutrition improved under it. At times, ulceration took place in the mouth, whereby the breath assumed a mercurial foetor, and salivation has been observed from it, according to Manson,1 Winslow,2 Ely,3 Mackall,4 and others ; but Riecke5 suggests, that this, perhaps, only occurred in those, who, along with the use of iodine internally, had employed the ioduret of mercury externally. On the genital organs, Eager found it to act as an excitant; it augmented the activity of the uterus, and rendered the catamenia more abundant. It is asserted, too, to have increased the sexual appetite, but this is questionable ; during its use, indeed, the testes in men, and the mammas in women, have been observed to disappear ;6 but this, as we shall see, is certainly not a common occurrence.7 On the other hand, it has been imagined to cause sterility. Two cases are detailed by Dr. Robert H. Rivers,8 in which barrenness succeeded to its admi- nistration. Magendie, on giving it as an emmenagogue to a young lady of unsuspected virtue, brought on abortion.9 Krimer several times observed, even when the tincture was given in small doses, considerable metrorrhagia, epistaxis, haemop- tysis, obstinate diarrhoea, leucorrhoea, &c. supervene under its 1 Op. citat. p. 61. 2 Lond. Med. Gaz. for 1836, p. 401. 3 Ibid. p. 480. 4 Medico-Chirurg. Review, Jan. 3836. 5 Die neuern Arzneimittel, u. s. w. S. 282. 6 Christison, Treatise on Poisons, p. 180; Cogswell on Iodine, p. 47; Edinb. 1837. 7 Pereira, in Lond. Med. Gaz. vol. xvii; and Diet, de Mat. Med., par Merat & De Lens, Art. lode. 8 American Journal of the Medical Sciences, Aug. 1831, p. 546. 8 Formulary, Gully's edit. p. 105. I0DINUM. 285 use. Cases of suppression of the hemorrhoidal flux are asserted to have been restored by it.1 Jahn2 found, in the bodies of two persons, who had long made use of iodine, wasting of the fat; softness and laxity of all the organs and tissues; diminution and disappearance of the glands, and glandiform bodies,—the mesenteric glands; suprarenal cap- sules, &c.,—and the cellular tissue appeared to exist in smaller quantity. In the case of a female, who died from the excessive use of the tincture, Zinck3 found the bowels inflated with gas ; in some parts highly inflamed; in others, exhibiting an approach to sphacelation, both within and without: the inner membrane of the stomach displayed redness, growing deeper from the cardiac to- wards the pyloric orifice, where the organ looked as if it had undergone corrosion; the liver was large and reddened; and there was ecchymosis of the spleen. Dr. Christison4 is of opinion that iodine is capable of inflaming the latter organ. From the testimony of many observers, it can scarcely be doubted that the iodine disease, or iodosis, or iodism, as it has been termed, may become dangerous to life : generally, however, it is not really so much so as it appears, and is considered to be, and the evil consequences may be readily avoided by proper foresight. Cases, however, have occurred, in which its use has been followed by fatal results ;5 hence the necessity of circumspection in the em- ployment of so energetic a therapeutical agent. To avoid evil consequences, Wutzer advises that the iodine should be immediately discontinued, whenever a feeling of in- creased heat in the pharynx and stomach is experienced imme- diately after it is taken; but as this evidence cannot be available in small children, attention should be paid, whether, after the medicine has been taken, the temperature of the skin becomes more elevated; the pulse quicker, and whether there is any evi- dence of pain when pressure is made on the epigastric region. He, moreover, advises, that it should not be given internally to children at the breast. It has been affirmed, that if the iodine be combined with small 1 See Ashwell, in Guy's Hospital Reports, vol. i.; and Cogswell, Op. cit. p. 43. * Archiv. fur medicin. Erfahrung, i, 342, 1829; and Journal Complement. du Diet, des Sciences Medicales, xxxv. 362. 3 Journ. Complem. du Diet, des Sciences Medicales, xviii. 231. 4 Treatise on Poisons. 6 Sir B. Brodie, Lancet, Mar. 30, 1839. 286 NEW REMEDIES. doses of opium, all the disadvantages, immediate and remote, may be avoided; and it is always more advisable to give it in small doses for a longer, than in very large for a shorter, period. At times, it will happen, that in chronic affections—in which it is chiefly used—its beneficial agency may not be decidedly manifested until after the lapse of four or five months; and it is important to bear this in mind, as both practitioner and patient are apt to become dissatisfied, unless the remedy exhibits its action more speedily. When the iodine acts beneficially, the appetite is augmented, or is not deteriorated; digestion improves, so that the patient is able to take more food, and experiences less inconvenience therefrom: the secretion of the bile is increased, and the evacuations are more copious, and of a yellower hue; the peristaltic action goes on more energetically, and the patient gains strength. Such, at least, are the signs that are considered by many to indicate that the iodine agrees ; but the absence of all disagreeable consequences is a suffi- cient index. To remove the symptoms of iodine disease, or iodosis, (iodkrank- heit,) general or local bloodletting has been employed; with warm bathing, the use of milk, emulsions of gum arabic, and the like, with rigid diet and rest. The preparations of hydrocyanic acid have also been given with advantage in the palpitation, tre- mours, and other nervous symptoms that sometimes follow the use of iodine. Precaution is requisite in the case of impressible, and also—it has been conceived—in robust persons,1 for fear of the supervention of hyperaemia. It is advisable, too, during its administration, to let the diet be sparing, and devoid of all heating qualities. Kolley2 remarks, that iodine occasionally exerts a most unfavourable influ- ence on the nervous system, so that in those, who are easily ex- citable, unusual pains may be brought on by the use of even three or four drops of the tincture;—these pains, at times, ending in vio- lent spasms. Such persons exhibit the impressibility, even under very minute doses, by fidgetiness or restlessness of the limbs, so that they can scarcely be kept quiet: after a time, numbness and heaviness in all the limbs: heaviness of the head, and a species of inebriation3 succeed, with violent cephalalgia, spasms, tremours of 1 Riecke, Op. cit. S. 284. 2 Journal Complementaire, xvii. 307. 3 Giddiness was observed by Dr. Manson, (Researches on the Effects of Iodine, p. 61, Lond. 1825;) Ashwell, (Guy's Hospital Reports, i. 136;) and IODINUM. 287 the limbs, paralysis,1 prostration, spasms, depravation of vision, and disposition to lamentation and distress. Some of these nervous symptoms we have occasionally noticed, when the dose of iodine has been rapidly augmented. Where the person is liable to gastric uneasiness, caution is requisite in the use of the remedy, as it not unfrequently occasions dyspepsia and violent gastrodynia. All febrile and purely inflammatory diseases, according to Kolley, forbid its use. Of late, Dr. Andrew Buchanan2 affirms, that he has never wit- nessed any of the unpleasant symptoms that have been ascribed to the iodine. He asserts, that he has never seen its use " followed by wasting of the testicles or mammae, by palpitations, faintness, ex- cessive debility, hurried, anxious breathing, dinginess of the sur- face, copious clammy sweats, increased menstrual discharge, or an oily appearance of the urine, which are enumerated amongst the symptoms characterising the supposed affection, termed iodism." As regards the wasting of the mammae and testicles, Mr. Pereira suspects it to be very rare. He has seen iodine administered, he remarks, in some hundreds of cases, and never met with one in which atrophy of either organ occurred. Magendie, also, remarks, that he has never witnessed these effects, although they are said to be frequent in Switzerland.3 Our own experience accords with that of those gentlemen. We have prescribed, and seen it pre- scribed, largely, both in public and in private ; yet no such results have ever supervened. In the Philadelphia Almshouse, great attention was paid to the condition of the testes, in several cases in which it was administered, yet no clear case of atrophy occurred.4 EFFECTS ON THE ECONOMY IN DISEASE. Iodine exhibits itself as a most efficacious remedy in a variety of diseases, in which it is desirable to augment the activity of the ab- sorbent system. In referring to its use in the following diseases, the remarks apply not only to the pure iodine, but to the hydrio- Lugol, (Essays on the Effects of Iodine in Scrofulous Diseases, O'Shaugh- nessy's translation, p. 73, Lond. 1831.) 1 Sir B. Brodie, Lancet, 1832; Manson, Op. citat.; and Sir A. Cooper, Lancet, ii. 147. 2 Lond. Med. Gaz. July 2, 1836. 3 Pereira, Elements of Materia Medica, pt. i. p. 114. Lond. 1839. 4 Dr. A. M. Vedder, in American Medical Intelligencer, for Sept. 1,1838. 288 NEW REMEDIES. dates of the alkalies, especially the hydriodate of potassa; the medical properties of which accord with those of iodine. Bronchocele.—The very first experiments made with iodine were on goitre. Coindet recommended it strongly in that affec- tion, and Formey1 first introduced it into Germany. Coindet gave, in the first instance, the tincture internally, and he remarked, that about a week after the commencement of its use, the skin over the goitre generally became less tense, the substance of the tumour felt softer, without the tumefaction having abated; the particular portions of the gland became more distinct, separated from each other, and less and less hard, until gradually a diminution was perceptible. Frequently the goitre disappeared completely, in the space of from six to ten weeks, under the continued use of the remedy. At an after period, he employed the iodine externally, in which form of administration, the evil consequences, sometimes induced by it, are less to be apprehended; and often its internal and external administration were combined. The efficacy of iodine in bronchocele, has received the most am- ple confirmation. Cases have been published by Hufeland, Grafe, Baup, Helling, Ziegler, Vollmer, Reiss, Paulitsky, Hirsch, Ulrich, Jager, Barchewitz, Meissner, Vogel, Wutzer, Seiler, Ficinus, Nieu- sta.dt, Hoffmann, De Carro, J. Reid, Manson, EUiotson, Lugol, and numerous others.2 We have administered it in fifteen cases of soft goitre, and in every one the disease was removed. In two of the cases, it recurred, but the hypertrophy was again dispersed under the use of the remedy. It has been recommended by some, that its exhibition should be preceded by a bleeding ; and as the abstraction of blood facilitates absorption, this may be advisable, especially where but little, if any, effect seems to be induced by it, after it has been administered for some time. Reid advises, that we should commence with its ex- ternal administration; and, at a later period, conjoin with it the internal. Although cases have been published, in which iodine has not answered the purpose of the prescriber, there can be no ques- tion, that it is the most efficacious agent in goitre that we possess ; but when the tumour has acquired a cartilaginous hardness, al- though it may be diminished under the use of the remedy, it can 1 Bemerk. tiber den Kropf, u. s. w. Berlin, 1820; and Hufeland's Journal, B. Ii. St. 4, S. 91. 2 Richter's Specielle Therapie. Berlin, 1S28, S. 214; and Dictionnaire de Matiere Medicale, &c. par MM. Merat & De Lens, Art. lode. I0DINUM. 289 rarely, or never, be wholly removed. Under such circumstances, however, every other remedy would be found equally fruitless. Glandular affections.—Besides the affections of the thyroid gland, there are others of different glandular bodies, in which iodine exhibits itself efficacious. Jahn used friction with it in induration of the liver, with advantage. Wutzer gave it in two cases of induration of the spleen, but no precise deductions could be made as to its individual efficacy, owing to its having been combined with other remedies. Milligan relates three cases of enlargement of the liver or spleen in children in which he gave the tincture with success, after mercurials had been used ineffectu- ally. M. Eusebe de Salle1 and Jahn employed it with success in enlargement of the testes; Riecke,2 too, found it of essential service in a case of great induration and enlargement of the testicle, which in the opinion of several physicians would require an operation. Jahn found it useful in a case of strumous induration of the sub- maxillary gland, and in one of tumefaction of the prostate, the consequence of mismanaged gonorrhoea. Krimer employed it beneficially in cases of tumefaction and induration of the mesen- teric glands; and Cerchari3 found an ointment, composed of a scruple of iodine and an ounce of unguentum rosatum, very effi- cacious in the cure of enlarged tonsils. He applies it to the tonsils morning and evening, by means of a small brush ; and he asserts that under its use the tonsils will in two months be restored to their natural dimensions. Any inflammation must be subdued before the ointment is had recourse to. Sir B. Brodie4 has used it sucessfully in similar cases; the en- larged tonsils being touched every day with a camel's hair pencil dipped in the tincture. Of its administration in other glandular affections, mention will be made presently. Scrofula.—Soon after the introduction of iodine into the materia medica, it was used externally in scrofulous affections; and at an early period was prescribed by Gordon, Sir A. Halliday,5and others, in such diseases, especially when combined with mercury. Their observations were confirmed by Magendie, Baup,8 Sablairoles, 1 Journal Complement, xix. 193, and Journal Universel, xi. 346. 2 Die neuern Arzneimittel, u. s. w. S. 286. 3 American Journal of Pharm. 2d series ii. 83. Philad. 1837. 4 Lancet, Mar. 30, 1839, p. 38. i Lond. Med. Repos. Sept. 1821. 6 Bibliotheque Universale, Dec. 1821. 37 290 NEW REMEDIES. Baron, Brera, Manson, and others. Wutzer used it in many cases of scrofula, and found it especially useful in the lymphatic (pastosen) form. In irritable cases, he was cautious of employing it as well as in hyperaemic conditions; and he found that when aggravation of the symptoms occurred, some concealed inflammatory disposition was the cause. More recently, Lugol1 has contributed to the more extensive employment of iodine in scrofula, and has especially re- commended the watery solution of iodine internally, and baths of iodine externally. The fortunate results of his trials, in the Hopi- tal St. Louis, were corroborated by a committee appointed for the purpose, by the Royal Academy of Sciences. It afforded eminent service in the different forms of scrofula ; but in scrofulous caries it merely induced improvement, never entire cicatrisation. Lugol regards iodine as the most efficacious remedy we possess in scrofula. Eager, in speaking of Lugol's method of managing scrofula, pro- perly lays great stress on the accompanying regimen—nutritious diet, cleanliness, bathing and exercise in the open air—which he re- gards as indispensable to a fortunate issue. He prefers the watery solution of iodine internally to all other remedies. Lugol and Eager unite, with the internal use of iodine, the external, in the form of ointment or solution ; for example in fistulee they employ it as an injection. To excite ulcers to cicatrisation, after appropriate pressure and injections have failed, Eager recommends that the skin, which has separated, at the margins of the ulcers, from the subjacent parts, should be destroyed by caustic or removed by the knife, but that this should not be practised until the scrofulous tendency has been somewhat got under. As a caustic, Eager re- commends, pulv. calcis viv. 3vj ; potass, caustic. 3v, to be made into a paste with spirit of wine, and to be applied a few lines thick; the skin will be destroyed in about five minutes. According to the same observer, iodine has exhibited its efficacy in various cases of periostitis, scrofulous swellings of the joints, and necrosis. In scrofulous ophthalmia, it was less beneficial. In scrofulous dis- charges from the nose and ear, iodine injections were commonly of service. Baudelocque2 likewise extols the preparations of iodine in scrofula; but in scrofulous affections of the bones, and especially in caries, as well as in scrofulous diseases of the skin, it appeared to him to be inefficacious. Many cases have been related by 1 Essay on the Effects of Iodine, &c. p. 48. 2 Etudes sur la Maladie Scrophuleuse. Paris, 1834; and London Lancet, May 25, 1839, p. 350; see, also, Cogswell on Iodine, p. 75. IODINUM. 291 Zinck, Maunoir, Manson, Weihe, Benaben, Bayle, and others, in which white swellings of the joints, of a scrofulous character, have been removed by its use. Wutzer has likewise offered favourable testimony in regard to it in affections of the bones, some of which were of a strumous nature. In several cases, so much disorganisation had occurred, that the loss of the whole limb was to be apprehended, yet the iodine arrested the destruc- tive process, and the limbs were preserved. In various scrofulous affections, the tincture of iodine was given by Dr. Kuhne1 with great success, and without any evil consequences. He made it, however, of half the usual strength, beginning with three drops, and gradually increasing the dose to fifteen. In tumefaction of the joints, the iodine, administered externally, has afforded essential service. Wutzer was of opinion, that the tincture of iodine might frequently be applied externally with greater advan- tage than the ointment; the alcohol readily evaporating and leav- ing the iodine on the skin ; for which reason he recommends that the tincture should be applied repeatedly by means of a camel's hair pencil. Tubercles.—The efficacy of iodine in scrofulous affections gave rise to the belief, that it might be serviceable in tubercles. Brera and Calloway administered it frequently in mesenteric tubercles with great success, and the observations of Krimer, referred to above, correspond with theirs. It has also been given with advan- tage in cases of pulmonary tubercles. It was suggested, in such affections, by Dr. Baron, and a case is related by Mr. Haden of ap- parent tubercles in which it was markedly useful ;2 similar examples are detailed by Jahn, Waldack, and others; and Berton affirms, that he has found inhalations of the vapour of iodine of decided efficacy in confirmed phthisis, as well as in certain form&of catarrh. It has likewise been advised in the form of vapour by Sir James Murray,3 and by Sir C. Scudamore4 in phthisical affections. The addition of a little tincture of conium was found by the latter gen- tleman to be beneficial in subduing the irritating qualities of the gas. His formula is the following: iodin. gr. viij, potass, iodid. gr. iij, alcohol, gss, aquae distillat. gvss. M. Of this solution, 1 Medicinische Zeitung, No. 34. August 24, 1836. Berlin. 2 Formulary—the Author's edition, p. 37. Lond. 1824. 3 On Temperature, Aliment, &c. 1829. 4 Cases illustrative of the efficacy of various medicines administered by inhalation in pulmonary consumption, 2d edit. Lond.; and Lond. Med. Ga- zette, Feb. 17, 1838, p. 804. 292 NEW REMEDIES. from one dram to six, and from twenty to thirty-five minims of a saturated tincture of conium are used in each inhalation, which is continued from half an hour to forty minutes. Sir Charles con- siders it better to add the conium at the time of employing the in- halation. At the temperature of 90°, the volatile properties of iodine are given off very sensibly, but the conium requires more heat, and that of 120° is not too much for the iodine. A learned reviewer in the British and Foreign Medical Review,' affirms, that his own experience leaves him no doubt as to the great value of the practice as a palliative in phthisis, and as an important remedy in bronchitis. It is true, however, he adds, that the relief has often been as great from the simple aqueous as from the medicated inhalation. Our own experience has not been favourable to it, and Mr. Pereira2 says he has repeatedly tried it in phthisis as well as in other chronic pulmonary complaints, but never with the least benefit. The inhalation may be practised in the method recom- mended under the head of Chlorine, (page 127.) The inhalation of iodine has been dreaded, because, in some in- stances, troublesome irritation of the larynx has followed its use; but Dr. Corrigan3 considers, that this injurious effect has resulted from the defective means of inhalation hitherto employed. Used in the manner he has recommended, and which we have described— under the article referred to above—gradual in its evaporation, and ultimately combined with a large portion of aqueous vapour, its use, he says, is positively free from any injurious irritative effects. The vapour he found to diminish most remarkably the profuse and wast- ing purulent expectoration of phthisis. The effects of iodine, thus used, on the digestive function were also very gratifying. In all the cases in which Dr. Corrigan employed it, the appetite and state of the intestinal canal were improved. It acted as a most useful tonic to the digestive organs, without any of the irritation, which its internal use, in the ordinary form, at times produces. It likewise greatly alleviated the cough, so that the patient was enabled to obtain hours of sound and refreshing sleep ; and he consequently con- siders, that even should its use be of little avail against the destruc- tive scrofulous ulceration, which constitutes phthisis, the palliative good, which is derived from it, renders it a valuable addition to our 1 April, 1838, p. 606. * Elements of the Materia Medica, Pt. i. p. 120. Lond. 1839. 3 Dublin Journal of Medical Science, for March, 1839, p. 103; and Lond. Med. Gaz. for April 6, 1839, p. 50. I0DINUM. 293 list of remedies. Dr. Corrigan has had his apparatus at work from eight to twelve hours in the twenty-four ; and his mode of managing it is as follows:—at night, when the patient is settling to sleep, the apparatus is suspended from the roof of the bed ; and, when once arranged, it continues its work quietly and silently for four or five hours, while the patient, asleep, is all this time inhaling the medicated air. In the morning, for three or four hours before the patient rises, it is again at work ; and, if necessary, in the midday, while the patient reclines on the bed, with the curtains drawn round three of the sides. The rate of evaporation, which generally gives a sufficiently strong impregnation to the air, is when the tincture of iodine drops from the cotton wick at the rate of from six to eight drops per minute. At this rate, about six drams of the tincture will be evaporated in an hour, and as every particle of the iodine is diffused in watery vapour through the air, there are thus diffused in the minutest state of division through the air, in every hour, about thirty grains of iodine. " If we suppose the patient to inhale only one twentieth of the iodine evaporated he will inhale in each hour, and apply to the diseased surfaces, one grain and a half of iodine in a state of the most minute division or solution." "This quantity we know"—adds Dr. Corrigan—"is quite suffi- cient to exert a decided action upon scrofulous ulceration; for we find on reference to Lugol's valuable work on the employment of iodine in scrofula, that in external scrofulous ulceration, the prepa- ration of iodine which is found beneficial, is a solution which con- tains only about three grains of iodine in each pint of fluid. The duration of the inhalation can, of course, be extended at pleasure." Fontana affirms, that he has observed decided benefit from iodine in a case of phthisis mucosa; when given in the form of the sy- rupus iodatus, and combined with the external application of the ointment of tartarised antimony. Duverney has communicated some cases, which appeared favourable to the prophylactic agency of iodine in incipient or threatened phthisis, but he himself con- siders, that his observations have not been sufficiently numerous to effect the demonstration. We have frequently administered iodine, in various forms, in pulmonary tubercles, but it must be confessed, not with that decided advantage, which the well known sorbefacient virtues of the remedy, and the recorded observations of others, might seem to promise. We have never witnessed, on the other hand, the evil, which Riecke1 mentions, that it may under particu- 1 Die neuern Arzneimittel, u. s. w. S. 289; see, also, Gunther, in Har- less's Neue Jahrb. B. xii. St. 3. S. 161. 294 NEW REMEDIES. lar circumstances, occasion the speedy development of phthisis, where tubercles exist in the lungs. He refers to a case by Haser, as corroborative of his opinion. A woman, fifty years old, was affected with anchylosis spuria, for which an ointment of iodine was recom- mended ; but it had not been employed more than three weeks, and not more than a dram of the hydriodate of potassa had been rubbed in, when symptoms of phthisis tuberculosa rapidly supervened, which, in half a year, terminated in death. There does not appear, however, in this case, to have been any thing more than a coinci- dence. In tubercles of the liver iodine has been regarded worthy of special consideration.1 Dropsy.—Many trials have been made with iodine in cases of dropsy, owing to its powerful sorbefacient agency.2 Bradfield and Bardsley exhibited it frequently with success in hydrothorax and ascites ; and Kissam, in a case of dropsy, dependent probably upon induration of the liver. Dr. Coster3 says he has removed many dropsies by giving internally from six to fifteen drops for a dose of a mixture composed of iodin. gr. hi., potass, hydriod. gr. vi., aquas, §j; aided by an ointment composed of fifteen grains of iodine, with double the quantity of hydriodate of potassa, to an ounce of lard. This to be placed inside the thighs after removing the cuticle by a blister. The armpits and soles of the feet were also rubbed with the ointment. The same plan is recommended by Dr. Osborne.4 Jahn regards iodine as one of the most important agents of modern discovery, and as an extremely valuable antihydropic.5 He first used it in a case of hydrocele, in which it was doubtful whether degeneration of the testicle had not been a precursor. The effect of the ointment of hydriodate of potassa left nothing to be desired; and, accordingly, he afterwards employed it in all cases of hydrocele of the tunica vaginalis, which he met with, even in the new born, united with mercury or extract of cicuta, and in every case, which was not of too chronic a character, it exhibited its sanative powers. The only unfavourable effects induced by it were a temporary disappearance of the testicle, in some cases; and a humid cutaneous eruption of the 1 Riecke, Op. cit. S. 290. 2 Dr. Wm. Stokes, in Amer. Journal of the Med. Sciences, May, 1834, p. 543, from London Med. and Surg. Journal. 3 Journal de Pharmacie, 1834. 4 On the Nature and Treatment of Dropsical Diseases, 2d edit. p. 48. Lond. 1S37; and Amer. Med. Library edit. Philad. 1838. 1 EUiotson, in Lancet, 1830—31. IODINUM. 295 scrotum. He also found the iodine extremely useful in hydrotho- rax and ascites ; especially in those cases of dropsy which succeed to exanthematous diseases, and that it acted more speedily and powerfully when combined with some diuretic. He found, farther, that the iodine was followed by the most beneficial results in the hydrocephalus of children—as well chronic as acute—especially when the latter form had attained its full development, that is, when the inflammatory stage was over, and the accumulation of fluid was the prominent condition. In these cases, he commonly used the iodine in the form of the hydriodate of potassa, made into an ointment, and rubbed on the head. Fre- quently, however, he gave the iodine also internally, in combina- tion with calomel and digitalis; but it may be objected to this combination, that iodine with calomel forms corrosive sublimate and the proto and deuto-iodurets of mercury, so that, in very small doses, it might affect the stomach too violently.1 M. Ricord2 em- ployed the tincture of iodine with success in five cases of hydro- cele ;—the tincture being diluted with distilled water, and applied by means of compresses wetted with it, and in which the scrotum was enveloped. He uses it of four different strengths—3j, 3ij, 3hj, and 3vj of the tincture, to giij of water. In hygroma, or dropsy of the bursas mucosae of the joints, an ointment of the iodide of potassium (3ij ad axung. |j) has been most successfully used by M. Reynaud.3 The limb is kept at rest, and morning and evening, or three times a day, friction is made with this quantity of ointment; after which the knee—the joint commonly affected—is covered with a large flaxseed poultice. From some trials made with the iodide of lead, there was reason to believe it more efficacious than the iodide of potassium. The treat- ment was generally successful in about a fortnight. As to its efficacy in nervous diseases, the testimony is somewhat discordant. Manson4 and EUiotson5 found it useful in paralysis, but Dr. Bardsley failed with it. Chorea was removed by Gibneyfi and Bardsley; and Franklin,7 by very large doses, relieved a case of epilepsy. 1 Riecke, Op. cit. S. 291. 2 Journal des Connoissances Med.-Chirurg. Janvier, 1833. 3 Cabissol, in Bulletin General de Therapeutique, Fev. 1S38. 4 Op. cit. s Lancet, 1830-31. 8 Ibid. 1827-8, p. 54. 7 Lancet, 1830, and Cogswell, Op. cit. p. 24. 296 NEW REMEDIES. The intimate affinity between iodine and the urinary organs, has given occasion to its employment in Incontinence of Urine.—Corter cured two cases by the tincture of iodine. Cutaneous Diseases.—Gases of dry, scaly tetter were treated, commonly, by Tunnermann, with an ointment made of the iodide of potassium, applied to the affected parts three or four times a day. For the most part, an increase of the evil was at first a pretty sure harbinger of a radical cure ; when this attained a certain de- gree, a change in the organic actions of the skin succeeded ; the remedy was then pretermitted, and the parts were washed a few times with soap, when the eruption faded away, and disappeared. In moist tetter, Tunnermann applies only a very weak salve, with which the parts are touched daily two or three times: in the intervals, he envelopes them in dry linen rag. The pain, which is always induced by the application, soon passes away. Magendie, Gimelle, and Jeffray1 have likewise applied it successfully in tetter. In chronic cutaneous diseases, in general, the various pre- parations of iodine are valuable remedies. They enter, as we have seen, the mass of blood, modify the condition of that fluid, and, in this manner, exert a new impression upon the capillaries of the diseased portions of the dermoid system. We have often employed them in these cases with success, and similar testimony has been afforded by MM. Biett, Gimelle, Kolley, Locher-Balber, and others. Brehme succeeded in removing, rapidly and completely, a case of inveterate porrigo favosa, and ophthalmia thereon dependent, by an ointment of iodine. Amenorrhea.—According to Coindet, iodine is a powerful em- menagogue, and the possession of this property has likewise been ascribed to it by Brera,2 who frequently administered it successfully in amenorrhoea; and Formey and Nieustadt confirm his observa- tions. Sablairoles cured three cases by frictions with iodine oint- ment on the breast, conjoined with the internal use of iodine. It was necessary, however, to give it in large doses, and for a long time. Locher-Balber3 found the iodine of use, at times, in those troublesome cases, which occasionally precede the establishment of menstruation; as well as Golis, who was, however, often deterred from its use, in such cases, by the evil consequences it produced on 1 Cogswell, Op. cit. p. 80. 2 Saggio Clinico sull' Iodio. 3 Hecker's Litter. Annal. i. 275; and Cogswell on Iodine, p. 77. IODINUM. 297 the respiratory organs,—such as dry cough, or cough accompanied by bloody sputa. Degeneration of the Ovaries.—Rbchling observed a marked effect from the use of iodine in induration of the ovary. Jahn cured, by an ointment of iodine and mercury, an enormous dege- neration of the ovaries, which gave rise to two tumours, each of the size of the head; and Messrs. Thetford,1 Klaproth,2 Jewel,3 and Ashwell4 were equally successful. Baron employed the iodine beneficially in a case of dropsy of the ovarium. Of hypertrophy of the mamma, Delfiz5 details a case which resulted favourably; and in hypertrophy of the thymus gland— the asthma thymicum of Kopp—iodine baths have recently been advised by Dr. Fingerhuth. In hypertrophy of the ventricles of the heart, Magendie long ago recommended it. In scirrhus of the uterus, mamma, Aoo{, inner bark, and |»£«, root. PHLORIDZINA. 349 The fresh bark of the root of the apple-tree is to be boiled for two hours with sufficient water to cover the bark : the decoction is to be decanted, and a second one made by the addition of more water. On uniting the two decoctions, and permitting them to stand for twenty-four hours, a deposition of phloridzine, in granular crystals, takes place. These are to be treated with distilled water and animal charcoal to purify them. An additional quantity is obtained by evaporating the mother waters to one-fifth. At this degree of con- centration, all the phloridzine is deposited. This method affords about one part in three hundred. Another plan yiejds five per cent. It consists in digesting the fresh root in weak alcohol, at a temperature of 120°, for about eight or ten hours, distilling off the greater part of the alcohol, and crystallising the residue.1 Phloridzine crystallises in silky spicula of a dead white colour when in masses, or in long slender prisms or tables when crystal- lised with care. One thousand parts of water, at a temperature from 32° to 71°, only dissolve about one part; but at from 71° to 212° water dissolves it in all proportions. It is also very soluble in pure alcohol at ordinary temperatures, although but slightly so in ether, even when boiling. It has no action on test papers. S. g. 1.429. EFFECTS ON THE ECONOMY IN DISEASE. M. de Koninck found, that from ten to fourteen grains given for a dose, with a dram of sugar, produced the most marked effect on intermittent fever, where quinine had failed. In four cases re- ported by Dr. Van Mons,2 of Bruxelles, the disease was arrested by the first sixteen grains; other cases required sixteen grains a few hours before the first paroxysm ; twelve grains before the second ; six before the third; and four before the fourth. Five successful cases are likewise given by M. Mathysen,3 eleve interne at the Hospital St. Pierre, Bruxelles; yet M. Leonhard4 is satisfied, from his various trials, that phloridzine does not possess any febrifuge virtue! METHOD OF PRESCRIBING. It may be given in the form of pill or of powder, like the qui- 1 Journal de Pharmacie, & Amer. Journ. of Pharmac. vol. ii. new series, p. 240. See, also, M. Boullier, in Gazette Medicale de Paris, 17 Juin, 1837. 2 Bulletin Medical Beige, Mai, 1836. 5 Ibid. Oct. 1835. 4 Encyclographie des Sciences Medicales, Mai, 1838. 350 NEW REMEDIES. nine. It was administered at the hospital at Bruxelles, in one case, in the way of lavement /—twenty-four grains being given in three lavemens. The paroxysm returned, but was less violent. In two days afterwards, the same quantity was administered in the same manner, and the fever did not recur. PIPERINA. Synonymes.—Piperinum, Piperine. German.—Piperin, Pfefferstoff. This substance was discovered by M. Oerstadt, in the year 1819, in the black pepper, (Piper nigrum.1) It is found, also, in the Piper longum, and it has been presumed to be the same, or an analogous principle with the cubebine of the Piper cubeba. M. Oerstadt at first regarded it as a vegetable alkali, but M. Pelletier subsequently analysed it, and proved it not to be such, but to bear a consider- able analogy to resins, and to be of a peculiar nature.2 Piperine has not been much used, except in Italy: it has been highly extolled there in the cure of intermittents, by Meli3 and many others. METHOD OF PREPARING. Let two pounds of black pepper, bruised, be digested, at a gentle heat, in three pounds of alcohol, at 36° (.837). This mixture must afterwards be raised to ebullition, then suffered to remain at rest, and grow cold; when it must be decanted, and the operation be repeated with fresh alcohol. The two solutions must then be mixed together, and two pounds of distilled water and three ounces of muriatic acid be added thereto. The liquor becomes turbid, and a precipilate, of a deep gray colour, is thrown down, which is com- posed, in a great measure, of fatty matter. The deposit being separated, crystals may be collected on the filter and sides of the ' Journal de Physique, No. 2, 1820, & Gazette de Sante, Mai 25, 1820. 2 Examen chimique du Poivre, par J. Pelletier, 8vo. Paris. 3 Annali Univers. di Medicina, xxvii. 161, & xxviii. 22. PIPERINA. 351 vessel. These are the piperine. On adding water until the liquid is no longer rendered turbid, a fresh quantity is obtained. The above process, which is that of Meli, is the same as one described by M. Pelletier. He has likewise procured it by the following method :—After having exhausted the pepper by alcohol, and evaporated the alcoholic tinctures, a fatty or resinous matter is obtained: this must be subjected to the action of boiling water, which must be added again and again, until it passes off colour- less. By dissolving this fatty matter—thus purified by washing in alcohol —by the aid of heat, and leaving the solution to itself for some days, a multitude of crystals are obtained, which may be purified by solution in alcohol and ether, and by repeated crystalli- sation. The alcoholic mother waters, left to themselves, will furnish fresh crystals. This crystalline matter is piperine. Piperine presents itself in the form of four-sided prisms, two of which—parallel to each other—are evidently broader than the others. In the pure state, it is of a white colour, and translucent; it is frequently, however, coloured yellow by portions of resin being combined with it. It is inodorous, and of a feeble taste of pepper; fuses readily by heat; is not volatile, and is scarcely soluble in cold water, but somewhat more so in hot. In respect to its solubility in alcohol, testimony is discordant. According to Magendie, it dissolves very readily therein ; according to C. G. Gmelin, it is soluble only in small quantity in cold, but in tolerable proportion in hot alcohol, as well as in ether and in the volatile oils. The solutions taste acrid and peppery, and do not react on vege- table colours;—which shows that it is not an alkaloid, as the dis- coverer conceived. With acids, it forms no intimate chemical combinations; acetic acid, indeed, dissolves it in considerable quantity, but it is in great part precipitated by water, and by eva- poration the whole of the acid escapes. EFFECTS ON THE ECONOMY. Piperine—as has already been remarked—has been exhibited chiefly by the Italian physicians for the cure of intermittent fever. Its employment was, doubtless, suggested by the use of pepper corns as a popular remedy in that disease. According to Riecke,1 the antiperiodic virtue of pepper is exhibited upon the healthy 1 Die neuern Arzneimittel, S. 361. 352 NEW REMEDIES. economy; a few pepper corns taken before the expected appear- ance of the menses, arrests them for several days. Of this, he him- self has had no experience; but he affirms that the females, in a district of southern Germany, have great confidence in their virtues. Meli,1 who treated many cases of intermittent with piperine, considers it as the best of all febrifuges, the quinine not excepted. He forms twenty grains into ten pills, and gives these at intervals during the apyrexia. The efficacy of the oleum acre piperis in the same complaint, he ascribes to the piperine it contains. The febrifuge virtue of piperine has been confirmed by many other Italian physicians; by Brandolini, Bertini, Gordini, Torelli, and others. According to Brandolini, from forty to fifty grains are generally required to effect a cure. Bertini gave it in three doses during the apyrexia, to the extent of a scruple, made into pills with a bitter extract: after two or three doses, the fever was generally arrested. Gordini affirms, that relapses occurred less frequently after the use of piperine than after that of the sulphate of quinine. On the other hand, in the hospital at Turin, Christin was dis- appointed in it, and such seems to have been the result of the trials made by Chiappa.2 In the year 1823, he administered it in ten or twelve cases, but was unable to detect any great antiperiodic property; not more than a fourth part of the sick experienced benefit, whilst, on the others, the cinchona acted like a charm. In general, a burning sensation was experienced in the stomach after taking it, as well as in the throat, with the same kind of feeling occasionally in the rectum, and in the whole abdomen ; and in two young individuals, the eyes were made red, and the eye-lids, nose, and lips v/ere swollen. Piperine has, likewise, been employed by others besides the Italian physicians. Dr. Blom, of Utrecht, has given it in inter- mittents, but not with as much success as the quinine. According to him, the remedy, soon after it is taken, particularly in very im- pressible persons, occasions a sense of internal heat, especially in the epigastric region, and not unfrequently k causes perspiration, especially on the upper lip. Blom is, however, doubtful, whether these effects are ascribable to the piperine, or to a portion of the resin of the pepper remaining united with it. He is of opinion, 1 Nuove Esperienze, &c, Milan. 1823, 8vo., & Annali Universali di Me- dicina, xxvii. 161, and xxviii. 22. 2 Riecke, Op. cit. S. 361. PLATINUM.—PLUMBI IODIDUM. 353 that both in general debility, and in debility of the digestive appa- ratus, piperine merits a preference over the sulphate of quinine, both because it can be better borne by the stomach, and because it acts more tonically upon it. In inflammatory intermittents, as well as in those with gastric complications, the piperine is to be avoided. Magendie suggests that it should be given in blennorrhoea, in place of the cubebs. METHOD OF ADMINISTERING. Pilula Piperina. Pills of Piperine. St. Piperin. gr. xij. Extract, gentian, q. s. ut fiant pilulae xij. Dose.—One every hour during the apyrexia of fever. PLATINUM. Synonyme.—Platina. The Preparations of Platinum are not given here, as they are not used. According to Magendie, they possess analogous proper- ties to those of the salts of gold. See Auri Praparata. PLUMBI IODIDUM. Synonymes.—Plumbi loduretum, Iodide or Ioduret of Lead. French.—Iodure de Plomb. German.—Bleiiodid. MODE OF PREPARING. This preparation may be made by adding a solution of one hun- dred parts of hydriodate of potassa to a solution of seventy-five parts of the acetate of lead. 45 354 NEW REMEDIES. The iodide is a fine yellow powder, insoluble in cold, but per- fectly soluble in boiling water, from which it is precipitated, on cooling, in hexagonal plates, partially soluble in alcohol and acetic acid. EFFECTS ON THE ECONOMY. The iodide of lead is not an irritant, when applied even to a denuded surface.1 M. Paton2 administered twelve grains of it to a cat of moderate size. In four hours the animal did not appear to experience any inconvenience; twelve more grains were then given ; in twelve hours the animal became uneasy, and constantly refused every kind of food. It appeared to suffer in the kidneys ; subsequently, it was attacked with violent colic, which caused it to jump to great heights. Three days after taking the iodide, it died, suffering dreadfully. The dissection was made twelve hours after- wards, when no traces of irritation were perceptible. M. Paton examined the interior of the stomach chemically, but was unable to detect any of the iodide, nor could any portion of it be dis- covered in the fasces. He then boiled the intestines and their contained matters in distilled water; the liquid was filtered and decolourised by charcoal, but no effect was induced by the tests for lead. The matter remaining on the filter was digested in dilute nitric acid : the solution was filtered, and a precipitate obtained on pouring in a solution of chromate of potassa. The liquid was eva- porated ; the residue calcined along with what was left by the evaporation of the water, and the whole brought in contact with dilute nitric acid. Nitrous gas was disengaged, and the solution responded to reagents like the solutions of the salts of lead. M. Paton infers, that the iodide of lead introduced into the stomach is partly absorbed, and that it is this portion which causes death,— the remainder passing into the intestines, and admitting of detec- tion by the method described. When given internally, in the dose of a quarter or half a grain, Velpeau thought that it occasioned, in one instance, irritation in the alimentary canal; but Dr. O'Shaughnessy thinks that this result must have been owing to idiosyncrasy, as ten grain doses can be 1 Eager, in Dublin Journal for 1834. 2 British Annals of Medicine, Mar. 3, 1837; and Journal de Chimie Medical, Jan. 1837. PLUMBI TANNAS. 355 borne with perfect impunity. The experiments of Dr. Cogswell1 show, that it is by no means an active agent. Owing to its not exciting cutaneous irritation—like iodine, and the iodide of potassium—the iodide of lead has been applied externally. Velpeau2 treated three cases of enlarged glands with very gratifying success, although the patients had used frictions with other prepa- rations of iodine ineffectually. Similar good effects were observed by Guersent, Roots, and others. Unguentum Plumbi Iodidi. (Pharm. Lond.) Ointment of Iodide of Lead. St. Plumbi iodid. §j. Adipis, oviij- M. Applied to scrofulous and other indolent swellings in the way of friction. PLUM13I TANNAS. Synonymes.—Tannate of Lead. French.—Tannate de Plomb. German.—Gerbstoffblei. Autenrieth3 has strongly recommended the tannate of lead in cases of paratrimma ad decubitum, that is, of sores produced by lying, and its advantages have been confirmed by others. METHOD OF PREPARING. The tannate is formed by precipitating an infusion of oak bark by acetate of lead, according to the following formula. St. Cortic. querc. gross, pulv. ^j. Coque cum Aquae commun. ^viij. Ad colaturae ^iv. admisce acetum plumbicum quamdiu prsecipatum inde oritur. Liquor filtretur per chartam bibulam. Praecipitatum in charta remanens ad consistentiam unguenti tenuioris exsicca.4 [ Essay on Iodine, p. 142. Edinb. 1837. 2 Lugol, Essays on Iodine, &c, by O'Shaughnessy, p. 206. 3 British Annals of Medicine, June 2, 1S37; and Journ. de Chimie Medicale, Mars, 1S37. * " Take of oak bark, in coarse powder, an ounce; boil in eight ounces of 356 NEW REMEDIES. The ointment is used, spread upon lint, three times a day. More recently, Dr. Tott has recommended the ointment in cases of decubitus gangranosus, or sloughing sores produced by lying.1 In one case, in which it appeared to be inefficacious, he took two drams of the dried precipitate, mixed it with an ounce of ungu- entum rosatum, and applied this unguentum plumbico-tannicum with success. POTASSA CHLORAS. Synonymes.—Kali Chloricum, Chloras Kalicus Depuratus, Alcali Vegeta- ble Salito-dephlogisticatum, Cbloruretum Potassae Oxidatum, Haloidum Oxygenatum, Murias Potassae Hyperoxygenatum seu Oxygenatum, Oxy- geno-chloruretum Potassii, Potassae Euchloras, Chlorate of Potassa, Chlo- rate of Protoxide of Potassium. French.—Chlorate de Potasse. German.—Chlorsaures Kali. METHOD OF PREPARING. In the chemical manufactories, the chlorate of potassa is pre- pared by passing chlorine gas into a solution of carbonate of po- tassa. In this way, chlorate of potassa is obtained mixed with more or less muriate of potassa. The salt prepared in the labora- tories, before it is adapted for medical use, should be purified by recrystallisation. It is to be observed, that when the adequate quantity of chlorine gas is not employed in the preparation, the re- sulting compound is analogous to the chlorides of soda and lime, and in action it agrees rather with those preparations than with the true chlorate of potassa. This may tend to explain the dis- crepancy in the experience of different physicians. The chlorate of potassa crystallises in white leaves, having the splendour of mother of pearl, or in four or six-sided tables, having a water, until, when strained, four ounces remain: add acetate of lead as long as any precipitate falls: filter the liquor through bibulous paper, and dry the precipitate remaining on the paper to the consistence of a thin oint- ment." 1 Grafe und Walther's Journal der Chirurgie, B. xxiv. S. 676, Berlin, 1836 j and Gazette Medicale, Jan. 1837. POTASSAE CHLORAS. 357 specific gravity of 1.989. It is permanent in the air, and has a cool, saline, disagreeable taste, similar to that of saltpetre. Six parts are soluble, at the ordinary temperature, in 100 parts of water. When exposed to heat oxygen escapes, and chloride of sodium remains. When beaten forcibly in a mortar, it crackles, emits light, and sparks. When rubbed lightly with inflammable sub- stances, or when struck, it inflames readily, and hence its well known employment in the formation of matches. EFFECTS ON THE ECONOMY. These have not been completely tested, in the opinion of some at least.1 L. W. Sachs, who has frequently administered it, is of opinion, that in the chlorate of potassa the direct effect of the alkali is rendered milder by the chloric acid, whilst the alkali modifies that of the acid ; in this manner, the caustic property of the alkali is destroyed ; whilst the liquifying or resolvent (fluidisirende) pro- perty is moderated, but not removed. On the other hand, by the union of the chloric acid with the alkali, the powerful excitant action on the nerves, which the former exerts, is at the same time markedly moderated, although certainly not destroyed; the mode in which it is exerted, he thinks, is probably changed. By such a union, a medicine has been supposed to be formed, which acts chiefly on the nervous system, and which is capable of mitigating and probably of removing any morbid erethism therein, with the hyperaesthesia thereby induced. Such is the opinion of certain therapeutists. Others imagine, that it is capable of purifying the mass of blood in consequence of the chlorine which it contains ; but a salt of chloric acid is not possessed of the same properties as chlorine; and, accordingly, when we have found occasion to administer it. we have never wit- nessed any of the effects ascribed to it; nor have we seen any evi- dence of the modus operandi on the nervous system mentioned above, or of its imparting oxygen to the blood as supposed by some.2 From its excitant properties, and under the notion that it may act upon the blood, and through the blood on the functions of nu- trition as an excellent alterative, the chlorate of potassa has been recommended in chronic cutaneous diseases in general, as well as 1 Riecke, Die neuern Arzneimittel, S. 300. * See Stevens on the Blood, p. 296. London, 1832. 358 NEW REMEDIES. in hepatic and syphilitic affections. It has also been occasionally administered in cases of chronic asthenia. Kohler1 employed it in several cases of tubercular phthisis, and although the general results of his experiments were unfavourable, he thinks it ought to be admitted into the number of those remedies that are useful in phthisis, although its stimulating action on the circulating and pulmonary systems cannot be denied. Its use is contra-indicated where the fever runs high, and where there is any sign of inflammation of the lungs, or tendency to haemoptysis. Sachs, in accordance with the views before mentioned, in regard to its antineuropathic properties, has advised it in cases of proso- palgia. He affirms, that in a great many instances it afforded essential relief. Chisholm appears to have been one of the earliest to prescribe it in neuralgia faciei; and, after him, Herber, and sub- sequently, B. Schaffer, Jos. Frank, Meyer, and others, employed it both as a curative and palliative agent in that disease. Recently, it has been advised in obstinate rheumatism of the ner- vous kind, by Knod von llelmenstreit; and Eyr has extolled it in ulceration of the mouth after violent salivation. Sachs administered it in the dose of from three to six grains, three or four times a day, but some give it in a much larger quan- tity. It may be administered either in the form of powder or of solution. Solutio Potassa Chloratis. Solution of Chlorate of Potassa. Synonymes.—Solutio Muriatis Potassae Oxygenati, Liquor ad Ulcera Atonica. S=. Potassae chlorat. gj. Aquee destillat. gxij. M. To be applied to indolent ulcers, by means of lint dipped in it, or of a camel's hair pencil, to excite the tissues. Swediaur..2 Potus Potassa Chloratis. Drink of Chlorate of Potassa. Synonymes.—Potus Oxygenatus. (French.—Tisane Oxygenee.) St. Solut. potass, chlorat. ftij. Aquae, ftiv. M. Given internally, in cases of general asthenia. Dose.—One or two pints a day. Swediaur. 1 Rust's Magazin, B. xlvi. 2 Phann. Med. Pract. Bruxelles, 1817. 2de edit. POTASSII BROMIDUM. 359 Mistura Potassa Chloratis. Mixture of Chlorate of Potassa. St. Potassae chlorat. jiss. Aquae destill. simpl. ^iv. Solve. Dose.—A spoonful every two hours. Helmenstreit. Eyr dissolves twenty:five grains of the chlorate of potassa in four ounces of distilled water, and administers a spoonful three times a day. St. Potass, chlorat. 3j. Aquae destillat. ^iv. Syrup, althsese, §j. M. Dose.—A table-spoonful four times a day. Koehler. POTASSII BROMIDUM. Synonymes.—Kalium Bromatum, Bromide of Potassium. In Solution Hydrobromate of Potassa, Potassae Hydrobromas, Kali Hydrobromicum. French.—Bromure de Potasse. German.—Bromkalium, Kaliumbromid, Bromwasserstoffsaures Kali. METHOD OF PREPARING. According to Liebig, this preparation can be readily made by dissolving bromine in spirit of wine, and adding caustic alkali until the spirit begins to change colour, then evaporating and heating to redness. In the London Pharmacopoeia, the bromide is directed to be made by adding first an ounce of iron filings, and afterwards two ounces of bromine to a pint and a half of distilled water. The mixture is set aside for half an hour, and frequently stirred with a spatula : a gentle heat is then applied, and when a greenish colour is produced, two ounces and a dram of carbonate of potassa, dissolved in a pint and a half of water, are poured in : what remains is filtered and washed with two pints of boiling distilled water, and again filtered. The mixed solutions are then evaporated, that crystals may form. Liebig says it crystallises in four-sided shining tables; accordino- to Balard,1 commonly in tubes, and at times in long rectano-ular 1 Annales de Chimie, torn, xxxii. 360 NEW REMEDIES. parallelopipedons. It has a pungent taste. By heat it crepitates, and melts into a red hot flux, without experiencing change. It is more soluble in hot than in cold water; producing, during its solu- tion, evident cold, and becoming converted into hydrobromate of potassa. It is also soluble in alcohol, although in small quantity. The solution of hydrobromate of potassa dissolves no more bromine than pure water. EFFECTS ON THE ECONOMY. The bromide of potassium excites the same phenomena as bro- mine, but with less intensity. From one dram and a half to 3ij is needed to kill a dog. The animal appears to suffer; is restless, and gradually falls into a state of prostration. In smaller doses it appears to act powerfully on the human stomach. The bromide, like bromine, seems first to have been applied to therapeutical pur- poses by Pourche.1 Two cases of scrofulous tumours are reported by him to have been removed by friction with an ointment com- posed thereof, and a cataplasm sprinkled with an aqueous solution of it. In a third patient, chronic otorrhoea and scrofulous tume- faction of the testicle yielded to the same agency, combined with the internal use of bromine. A very large goitre was reduced two thirds by it. Pourche prescribed the bromide internally in the form of pill, in the dose of four to eight grains in the day. Magendie2 employed the preparations of bromine in scrofula, in amenorrhcea, and in hypertrophy of the ventricles of the heart. Prieger recommended an ointment of the " Kali bromicum" in inveterate porrigo favosa as well as in obstinate and malignant tetter, and with good success; and Dr. Williams3 in cases of en- larged spleen. The last gentleman suggests, that it possesses "unusual, if not specific powers in the cure of diseases of the spleen!" It was owing to these results that the bromide was in- troduced into the London Pharmacopoeia of 1836.4 Dr. Williams also gave it with success in a case of ascites. •Journ. de Chimie Medicale, iv. 594; see, also, Bulletin General de Therapeutique, No. 14, Juillet, 30, 1837. 2 Formulaire, Ed. cit. 3 Elements of Medicine, i. 338. 4 Pereira, Elements of Materia Medica, Pt. i. p. 287. Lond. 1839; and Brande's Diet, of Mat. Med. p. 126. Lond. 1839. POTASSII CYANIDTJM. 361 MODE OF ADMINISTERING. Solutio Potassii Bromidi. Solution of Bromide of Potassium. St. Potassii bromidi, gr. xviij. Aquae lactucae destillat. ^iij. Syrup, althaeas, ^j. M. To be given in the course of the twenty-four hours: in table- spoonfuls. Magendie. Unguentum Potassii Bromidi. Ointment of Bromide of Potassium. St. Adipis, %j. Kalii bromat. gr. xxxvj. M. Half a dram to a dram to be rubbed on scrofulous swellings. Magendie. M. Pourche* employs 3j of the bromide to the ounce of lard. St. Axung. gj. Potassii bromid. gr. xxiv. Bromini liquid, gr. vi ad xij. M. Magendie. POTASSII CYANIDUM. Synonymes.—Potassii Cyanuretum, Cyanide, or Cyanuret of Potassium. French.—Cyanure de Potassium. German.—Cyankalium. This preparation was proposed by MM. Robiquet and VillermeV as a substitute for the hydrocyanic acid. It is, in their opinion, far more certain in its effects than that preparation. METHOD OF PREPARING. The cyanide of potassium is formed whenever potassa is cal- cined with an animal matter, as in the preparation of the Prussian blue. It is commonly prepared, after the process of Robiquet, by exposing to long continued heat the ferruginous prussiate of po- 1 Bulletin de la Societe Medicale d'Emulation, Juillet, 1823. 46 362 NEW REMEDIES. tassa. The cyanuret of iron is completely decomposed, and that of the potassium remains. The residuum, after this strong calcina- tion, constitutes a solid, blackish mass, which consists wholly of the cyanide of potassium, soiled by the iron and the charcoal be- longing to the cyanuret of iron. The mass is dissolved in water, when the iron and charcoal are deposited; whilst the cyanide of potassium dissolves, and is transformed into hydrocyanate of potassa. When the process has been well conducted, the solution is per- fectly colourless, and retains no portion of iron. M. Chevallier1 considers this process to be impracticable, as the cyanide decom- poses water on coming in contact with it. The result, therefore, must be hydrocyanate of potassa; and, on heating this, all the hydrocyanic acid escapes, and the residue is merely potassa. He prepares the salt by calcining the ferro-hydrocyanate of potassa, and then separating the cyanide from the quadricarburet of iron by pure alcohol: on distilling this, the eyanide is obtained very pure. Pure cyanide of potassium is white and transparent; it may be fused in the fire without being decomposed, and keeps for an in- definite period, provided it be kept dry. EFFECTS ON THE ECONOMY. MM. Robiquet and Villerme performed some experiments on animals in the presence of Magendie.2 A tenth of a grain de- stroyed a male linnet in a minute; less than a grain killed a guinea pig in two or three minutes : a small drop of the hydro- cyanate of potassa, containing only the hundredth part of a grain of the cyanide in solution, caused a linnet to drop down dead in half a minute. Haifa dram, containing five grains of the cyanide, killed a dog of large size in a quarter of an hour. Magendie proposes, that the cyanide of potassium should be dis- solved in eight times its weight of distilled water, when it becomes transformed into hydrocyanate of potassa. To this solution, he gives the name medicinal hydrocyanate of potassa, and advises, that it should be given under the same circumstances, and in the 1 Journ. de Chimie Medicale, and Journal of Phila. College of Pharmacy, 1832. 2 Formulaire pour la Preparation &c. de plusieursNouveauxMedicamens, &c. POTASSII CYANIDUM. 363 same doses, as the medicinal hydrocyanic acid, (see page 3.) He farther suggests, that, to render it wholly independent of the action of the small portion of alkali contained in the cyanide, a few drops of some vegetable acid may be added, or it may be prescribed with an acid syrup. The dose of the cyanide is a quarter of a grain at first, gradually increased to a grain and more. M. Bally gave it to fifty-two indi- viduals labouring under different diseases; it produced no effect on thirty-five; and, on the others, the result was neither constant nor salutary, so that he is not inclined to place more reliance upon the cyanide than upon the hydrocyanic acid. By Dr. Lombard,1 of Geneva, it has been applied externally, with success, in some cases of facial neuralgia. He uses it by fric- tion, in the form of watery solution, or of ointment, according to circumstances. The watery solution is in the strength of from on*3 to four grains to the ounce of water; and the ointment is composec of from two to four grains of the cyanide to an ounce of lard. Tht aqueous solution, however, is considered by Dr. Lombard to be the most prompt in its effects. Dr. Lombard regards the cyanide to be contra-indicated, where the nervous affection is complicated with inflammatory action. He has found it, also, a useful remedy in chronic rheumatism. In sciatic neuralgia, it was not successful. In white swelling, attended with acute pains, poultices moistened with the solution, gave great relief. Dr. Lombard, indeed, affirms, that the soothing properties of the cyanide are superior to those of any remedy known. Lotions of hydrocyanic acid are not to be compared with it,—the acid being decomposed with facility, and not devoid of danger. MM. Trousseau and Rullieraalso recommend the cyanide, in the proportion of four grains to an ounce of water, as a local applica- tion in various forms of neuralgia. M. Andral3 employed the cyanide with complete success in a case of most intense cephalalgia, which, for ten months, had re- sisted the most powerful remedies, as bleeding, a seton in the neck, blisters and sinapisms. It was employed in solution, in the pro- portion of from six to eight grains to the ounce of distilled water ; and compresses, wet with the solution, were applied, for eight days, to the forehead and temples. 1 Gazette des Hdpitaux, & Lond. Med. Gaz. Sept. 1831. 2 Lond. Med. and Surgical Journ. Dec. 15, 1832; and Amer. Journ. of the Med. Sciences, May, 1833, p. 238. 8 Gazette Medicale, Jan. 1832. 364 NEW REMEDIES. MODE OF ADMINISTERING. Mistura Potassii Cyanidi. Mixture of Cyanide of Potassium or of Hydrocyanate of Potassa. (Pectoral Mixture, of Magendie.) St. Potass, hydrocyan. med. 3j. Aquae destillat. Oj. Sacchar. purif. §iss. M. Dose.—About five drams (a table-spoonful) night and morning. (Pectoral Potion.) St. Potass, hydrocyan. med. gtt. xv. Infus. hederi terrestr. §ij. Syrup, althsese, §j. M. Dose.—Five grammes (a tea-spoonful) every three hours. Magendie. St. Potassii cyanid. gr. $. Aquae lactucae, ^ij. Syrup, althaeae, 3j. M. Dose.—Five drams (a table-spoonful) every two hours. Magendie. Syrupus Potassa Hydrocyanatis. Syrup of Hydrocyanate of Potassa. St. Potass, hydrocyanat. medic. 3j. Syrupi, Bj. This syrup may be added to pectoral draughts, and may be sub- stituted for other syrups. Pilula Potassii Cyanidi. Pills of Cyanide of Potassium. St. Potassii cyanid. Amyli,.aa. gr. iv. Syrup, q. s. ut fiat massa in pilulas viij dividenda. Dose.—A pill night and morning, in convulsions, dyspnoea, &c. Hospital of La Pitie'.1 1 Ryan's Formulary, 3d edit. p. 392. Lond. 1839. POTASSII IODIDUM. 365 POTASSII IODIDUM. Synonymes.—Kalium Iodatum, Kali Hydroiodinicum, K. Hydroiodicum, Hydroiodas Kalicus, Potassii loduretum, Iodide or Ioduret of Potassium. In solution—Potassae Hydriodas, Potassii Proto-hydriodas, Potassii Pro- toxidi Hydriodas, Hydriodate of Potassa. French.—Hydriodate de Potasse, Iodure de Potasse. German.—Iodkalium, Iodwasserstoffsaures Kali. METHOD OF PREPARING. According to Tunnermann, the iodide of potassium is best pre- pared in the following manner : One part of pure iron filings, with four parts of iodine, is put into a glass vessel—by many, into a glass retort—and six or eight parts of water are poured thereon ; gentle warmth is then applied, and the mixture is frequently shaken until the liquid appears clear and almost colourless. In this way, hydriodate of protoxide of iron is formed, which is dissolved in the water. It is now filtered ; the residuum washed several times on the filter with distilled water, and, under the application of a moderate heat, a concentrated solu- tion of potassa is added, by small portions at a time, until a precipi- tate is no longer thrown down. In this process, the potassium separates the iodine from the hydriodic acid; the oxygen of the former unites with the hydrogen of the latter; protoxide of iron is precipitated, and carbonic acid given off,—heat being required for its entire disengagement, to prevent the formation of a carbonate of protoxide of iron with excess of acid, which would be soluble in the water. It is then filtered, the residue washed on the filter with distilled water, and the liquid evaporated so as to form crystals. Those chemists or pharmaciens, who are not very accurate in their preparations, evaporate the mother waters to dryness, satisfy- ing themselves, that although the saline residuum contains car- bonated alkali, it may answer for external use ; which is decidedly objectionable. To prevent the loss of the iodide, owing to its ad- mixture with the carbonate of potassa, in the mother waters, Tunnermann finds it most advantageous to neutralise it with the hydriodic acid, which may be prepared in the following manner: Dissolve about one dram of iodine in not very strong spirit of wine, and pass a stream of sulphuretted hydrogen into the solution, until it is wholly deprived of colour. The hydrogen unites with the 366 NEW REMEDIES. iodine,—the hydriodic acid, thus formed, remaining dissolved, whilst the sulphur is precipitated. The liquor is then filtered, the sulphur washed with a little water and the spirit and superfluous sulphuretted hydrogen gas are driven off by heating it in a glass vessel placed in a sand bath. The remaining fluid is diluted with water, filtered, and a warm alkaline ley added, until litmus paper is only feebly reddened. By evaporation, the iodide of potassium is obtained, which, by repeated solution in water, evaporation of the solution, and filtration, is obtained entirely pure.1 The process of Turner is, to take any quantity of a solution of caustic potassa, and to add to it gradually, at a gentle heat, iodine sufficient to neutralise the alkali; then evaporating to dryness, calcining strongly, dissolving in water, and crystallising. Dr. William Gregory2 suggested an improvement on the process of Turner, which has been regarded one of the simplest.3 It con- sists in adding iodine to a hot solution of potassa until the fluid assumes a yellowish brown colour, then evaporating, and heating the residuum to low redness, in a platinum crucible. The mass which at first consists of iodide of potassium and iodate of potassa, thus loses all its oxygen, and becomes converted into iodide of potassiu m. The formula of Caillot and Baup is—to take ten parts of iodine and fifty of distilled water; put them into a mattrass, and add, in small successive portions, of pure iron filings, five parts, shaking the vessel each time. The liquor is then heated until it loses its colour, filtered, and the substance on the filter washed with boiling water, until the liquid is tasteless ; the liquor, and the various liquids used in the washings, are united, and the whole is heated in a sand bath. When the temperature approaches that of ebullition, enough of a solution of subcarbonate of potassa is added, to precipitate all the oxide of iron ; it is then filtered, and the sub- stance on the filter washed until it is completely exhausted. All the liquors are then united, tested by reddened litmus paper, and if there be any excess of base, a little hydriodic acid is added. It is then evaporated in a sand bath, until a slight pellicle forms; the fire is now discontinued, and the salt is suffered to crystallise. Lastly, the crystals are washed with a little water, and then dried.4 1 Riecke, Die neuern Arzneimittel, S. 305. Stuttgart, 1837. 2 Edinb. Med. and Surg. Journ., xxxvi. 369, for Oct. 1831. 3 Cogswell, on Iodine, p. 85. 4 Jourdan's Pharmacopee Universelle, i. 662. Paris, 1828; also the Lond. Pharmacopcehi, and Brande's Dictionary of Materia Medica, p. 317. Lond. POTASSII IODIDUM. 367 The iodide of potassium crystallises in beautiful cubes. These are readily fused, and are volatilised at a red heat. They do not decompose, even when heated with access of air. They are readily soluble in water, and in alcohol, and the addition of the iodide facilitates greatly the solution of the iodine. It would seem, that a slight contamination of iodide of potassium with carbonate of potassa is exceedingly common, as it can with difficulty be avoided in (he manufacture of the salt; but Christison1 affirms, that he has examined specimens, where the carbonate, with its accompanying water, amounted to 90 parts in the 100. " Can we wonder, then," he asks, " that practitioners should complain of the iodide of potassium, that they have given it for months, nay, even for years, without observing any effect either on the constitu- tion, or on the disease for which it was administered ?" EFFECTS ON THE ECONOMY. As respects the action of the iodide, and its administration in disease, it is scarcely necessary to do more than refer to what has been said under the head of iodine. On the whole, its effects appear to accord with those of iodine; at least, no difference is perceptible on the organism. It has been supposed, that it is to be preferred to pure iodine, where the object is to act especially on the urinary organs.2 For external use, the iodide of potassium is usually pre- ferred to pure iodine. It is constantly given internally, and often in combination with the latter; the solubility of which, as was before remarked, is aided by it. Many of the following formulae contain both one and the other. Dr. Buchanan asserts, that he has given the iodide of potassium in doses of gss, and the only precaution he observed was to make the patient drink freely of diluents. It was chiefly to determine some physiological questions that he gave it in such large doses. Two drams of it were taken by a young man affected with gonor- rhoea, and as soon as the medicine made its appearance in the urine, blood was drawn from the arm. On examining the blood, both the serum and crassamentum were found deeply impregnated with iodine.3 1 Edinb. Med. and Surg. Journal, April, 1838. 2 Riecke, Die neuern Arzneimittel, u. s. w. S. 306. See, also, Cogswell on Iodine, p. 96. » Lond. Med. Gaz. July 2, 1836. 368 NEW REMEDIES. According to recent experiments of Magendie,1 the iodide is one of the substances that promote the coagulation of the blood. METHOD OF ADMINISTERING. Liquor vel Solutio Potassii Iodidi. Solution of Iodide of Potassium. (Synonymes.—Potio resolvens ex lodio, Solution de Coindet, Coindet's Solution.) St. Potassii iodidi, gr. xxxvj. Aquae destillat. 3J. Solve. Dose.—Same as that of the tincture of iodine. Coindet and Magendie. St. Potassii iodidi, gj. Aquae destillat. 5J. Solve. Dose.—Fifteen drops three times a day, gradually increased to forty-five: in cases of ovarian dropsy,—frictions with iodine oint- ment being used at the same time. Elliotson. Liquor vel Solutio Hydriodatis Potassa Iodureta. Solution of Ioduretted Hydriodate of Potassa. St. Iodin. 9j. Potassii iodid. 9ij. Aq. destillat. ,§vij. Solve. Dose.—Six drops early in the morning, and in the middle of the day, in a glass of sugared water. In tetter, scirrhus, &c. Lugol. Lugol has a solution of three strengths for internal use. I. II. III. St. Iodin. gr. %. gr. i. gr. Ii. Potass, iodid. gr. iss. gr. ii. gr. iiss. Aq. destillat. § viij. ^ viij- §viij. Dose.—Two-thirds, daily, at first; afterwards, the whole. Lugol recommends this threefold solution in the same cases as his threefold solution of iodine; the first being continued from fourteen days to three weeks ; the second, from the fourth or fifth week of the treatment to its termination ; the third, the strongest, 1 Lemons sur le Sang; & translation in Lancet, for Jan. 26, 1839, p. 636. POTASSII IODIDUM. 369 he did not often use. As Riecke has observed^ it would be better to have in the hospitals but one solution, which might be prescribed in varied doses. Liquor Potassii Iodidi Compositus.—(Lond. Pharmacopoeia.) Compound Solution of Iodide of Potassium. St. Iodin. gr. v. Potass, iodid. gr. x. Aquae destillat. §xx. M. Dose.—f. 3ij to f. 3vj. Tinctura Iodinii Composita.—(Lond. Pharmacopoeia.) Compound Tincture of Iodine. St. Iodin. ^j. Potass, iodid. ,gij. Sp. rectif. Oij. M. Dose.—Ten minims. Mistura Hydriodatis Potassa lodureta. Mixture of Ioduretted Hydriodate of Potassa. St. Iodin. gr. ss. Potass, iodid. ^ss. Syrup, papav. §ss. Aq. destillat. ftss. Dose.—Two table-spoonfuls three times a day; in cases of complication of syphilis with scrofula. Tyrrel. St. Iodin. gr. iss. Potassii iodid. gr. iij. Solve in Aqua? menth. pip. %iv. Dose.—A spoonful two or three times a day. To children, a tea-spoonful. In cases of cancrum oris ; also, in dropsy, gleet, and leucorrhcea. On renewing the prescription, the dose of the iodine may be increased one half, and of the iodide one grain, each time. Coster and Friedrich. Mistura Potassii Iodidi. Mixture of Iodide of Potassium. *. Potass, iodid. ^iv. Aqua? lactuca? destill. ^viij. ----menth. pip. 3ij. Syrup, althaea?, 3j. M. Dose.—A spoonful morning and evening, in a little water, in- 47 370 NEW REMEDIES. creasing the dose to two spoonfuls. In cases of hypertrophy of the ventricles of the heart. Magendie. St. Potass, iodid. jiv. Aq. destill. lactuc. gviij. ----flor. naphth. 3rj. Tinct. digit. 3j. ad ^ij. Syr. althaea?, §iss. M. Dose.—Morning and evening, a spoonful, in a little water. In hypertrophy of the ventricles of the heart, with quickening of the heart's action. Magendie. St. Lign. quassia?. Rad. gentian, aa. gj. Aqua? fervent, ^xvj. Macera per horam et cola. Liquor, colat. add. Potass, iodid. gr. xxxvj. Potassa? carbonat. gij. M. Dose.—A table-spoonful three times a day, in a glass of water. Cumming. Pilula Potassii Iodidi. Pills of Iodide of Potassium. St- Potass, iodid. gr. xv. Aq. destillat. q. s. Pulv. spong. ust. Ext. dulcamar. aa. 31 j Pulv. rad. glycyrr. q. s Fiant pilula? clxxx. Dose.—Six, two or three times a day, in scrofula, goitre, &c. Vogt. Unguentum Iodinii Compositum.—(Pharm. Lond.) Compound Ointment of Iodine.—Ioduretted Ointment. St. Iodin. 3ss. Potass, iodid. 3j. Spirit, rectif. f. gj. Adipis. gij. Rub the iodine and iodide with the spirit; and mix with the lard. Unguentum Potassii Iodidi. Ointment of Iodide of Potassium. St. Potass, iodid. ^ss. Adipis, ^iss. M. Half a dram at first, and, subsequently, a whole dram to be rubbed in. In goitre, scrofulous glandular affections, &c. POTASSII IODIDUM. 371 This ointment is generally too weak, unless combined with the internal use of iodine in some form. Magendie. St. Potass, iodid. 9j. Adipis. .gss. M. The wounded parts to be smeared with it two or three times a day: in moist tetter—serpigo. Between the applications, to be dressed with dry lint. Tuennermann. In dry tetter, the ointment applied is formed of 3j to 3iss of the iodide to §j of lard. Unguentum Kali Hydroiodici. (Pharmacop. Borussic.) Ointment of Hydriodic Kali. St. Potass, iodid. 3j. Magnes. carb. gr. vj. Aq. destillat. guttas nonnullas ; M. terendo cum, Ung. rosat. §j. M. Or, 9*. Potass, iodid. Soda? carbon, depur. sice. aa. sjss. Ung. rosat. giv ad ^vj. M. A piece of the size of a small bean, to be rubbed in, morning and evening. In chronic enlargement of the testis. Walther. St. Potass, iodid. ^ss. Ext. opii. 9ss. Cerat. gj. M. As a dressing to malignant cancerous ulcers. Unguentum Potassii Iodidi loduretum. Ointment of Ioduretted Iodide of Potassium. St. Iodin. gr. xij. Poiass. iodid. 9iv. Adipis, ^ij. M. In scrofulous ophthalmia, ulcers, &c. Lugol. St. Iodin. gr. xv. Potass, iodid. £j. Tinct. opii. jij. Adipis, 3ij. M. In painful scrofulous ulcers, white swellings, &c. Lugol. Emplastrum Potassii Iodidi loduretum. Plaster of Ioduretted Iodide of Potassium. St. Iodin. Potass, iodid. aa. 9ss. ad 9j. Emplastr. hydrarg. Seu Saponis ,§ij. 372 new remedies. Applied in syphilitic and gouty swellings of the bones. Ebers. Lotio Potassa Hydriodatis Iodureta. Lotion of Ioduretted Hydriodate of Potassa. St. Iodin. gr. i. ad ij. Potassii iodid. gr. ij. ad iv. Solve in Aqua? destillat. ^viij. This solution was commonly used by Lugol externally, to be injected under the eyelids in strumous ophthalmia, fistulas, &c. Lugol. Solve in St. Iodin. ^ss. Potassii iodidi. ^j. Aq. destillat. ^vj. This "rubefacient solution of iodine," may be used two or three times a week, when the last prescription loses its effect, or when it is desirable to stimulate more actively. It is also added to baths— three or four ounces to an ordinary bath—as well as to poultices, being mixed with an ordinary cataplasm. Lugol. S>. Iodin. ^j. Potass, iodid. ^ij. Solve in Aqua? destillat. ^ij. This " caustic iodine solution" has to be used when the last loses its efficacy. It occasions a crust on the parts. Lugol employs it chiefly, when the skin on the edges of the ulcers is greatly hyper- trophied, red, and fungous, as well as in phagedenic or spreading tetters. It may be applied two or three times a week, or daily, should the case require it. Lugol. Collyrium Potassa Hydriodatis loduretum. Collyrium of Ioduretted Hydriodate of Potassa. St. Iodin. gr. ss. ad i. Potassii iodid. 9ss. Solve in Aq. rosar. J iij. M. To be applied four times a day, in cases of scrofulous ophthalmia, with ulceration of the conjunctiva and cornea. Magendie. potassii iodo-hydrargyras. 373 POTASSII IODO-HYDRARGYRAS. Synonymes.—Iodo-Hydrargyrate of Potassium. Iodhydrargyrate of Ioduret of Potassium. Dr. A. Channing,1 who has highly extolled this preparation in various diseases, affirms, that this, with other new salts, was dis- covered by Bonsdorf, of the University of Finland, in 1826; and it is a fact well known to the chemist, that iodine, chlorine, &c. enter into combinations so as to form both acids and bases. By experiment, Dr. Channing ascertained, that a solution of eight grains of the pure iodide of potassium in ten or fifteen minims of water, would combine with a fraction less than eleven grains of the deuto-iodide of mercury, maintaining the combination in solu- tion, when diluted with water or alcohol to any extent. If n ore than eleven grains of the deuto-iodide be added, although a small excess is dissolved in the concentrated solution, on diluting with water, it is promptly precipitated. It would appear, therefore, as Dr. Chan- ning has remarked, that in preparing this salt for administration, the labour of crystallising it, in order to obtain a solution of a de- finite strength, is wholly unnecessary; inasmuch as a solution, combining a fraction more than eight grains of the iodide of potas- sium with eleven grains of the iodide of mercury, may be used as containing twenty grains of the iodo-hydrargyrate of potassium. If it be desirable to obtain the preparation in a crystallised form, it is important, that the definite proportions of the two iodides be observed, and particularly that there be no excess of the iodide of mercury ; for the saturated solution of eight grains of the iodide of potassium will dissolve, and enter into combination with more than thirteen grains of the iodide of mercury, forming similar crystals soluble in alcohol, but in water precipitating more than two grains of the iodide of mercury. EFFECTS ON THE ECONOMY. These are similar to those of the iodides of mercury, but, ac- cording to Dr. Channing, in a less degree. The iodo-hydrargyrate is not, however, much employed, experience seeming to have shown, that it possesses no essential, if, indeed, any advantages 1 American Journal of the Medical Sciences, Feb. 1S34, p. 388. 374 NEW REMEDIES. over those preparations. Puche1 has recently recommended it as not being so subject to produce salivation, or pains in the bones, as the other combinations of mercury and iodine. METHOD OF ADMINISTERING. Mistura Potassii Iodo-Hydrargyratis. Mixture of Iodo-Hydrargyrate of Potassium. St. Hydrarg. deuto-iodid. gr. iv. Potassii iodid. 9j. Aqua? destillat. §j. M. Dose.—Five drops three times a day. Channing. Tinctura Potassii Iodo-Hydrargyratis. Tincture of Iodo-Hydrargyrate of Potassium. S>. Potass, iodo-hydrarg. gr. j. Spiritus vini tenuioris ^j. M. Dose.—Ten drops three times a day. Channing, Solutio lod-Hydrargyratis lodureti Potassii. Solution of Iod-Hydrargyrate of Ioduret of Potassium. St. Hydrarg. biniodid. gr. viij. Potassii ioduret. gr. viij. Aqua? destillat. 3viij. Dose.—f. 3ij to f. §ij in twenty-four hours. Puche. Pilula lod-Hydrargyratis lodureti Potassii. Pills of Iod-Hydrargyrate of Ioduret of Potassium. St. Hydrarg. biniedid. gr. viij Potassii ioduret. gr. viij. Sacchar. lact. gr. lxiv. Aqua? gum. q. s. ut fiant pilula? xxxij Dose.—One to eight, daily. Puche. •Journal des Connaissances des Medicales, Oct. et Nov. 1838, and Jan- vier, 1839, and Annales de Chimie, Oct. 1838. QUININA. 375 GIUININA. Synonymes.—Chininum, Chinium, Quininum, Q,uinium, duinia, Kininum, Q,uina, Sal Essentiale Corticis Peruviani. French.—Quinine, Kinine. German.—Chinin. Quinine is, doubtless, a most important gift from modern analy- tical chemistry to medicine. Not many years have elapsed since the discovery of this substance, and yet, by general consent, it is now regarded as one of the most valuable remedies in the cata- logues of the materia medica. The honour of the discovery—which had been facilitated by the investigations of other chemists, as to the composition of the cinchona barks—belongs to Pelletier and Caventou, (1820 ;*) and so rapidly and extensively was its efficacy promulgated, that in the year 1826, in two laboratories in Paris for the preparation of quinine, fifty-nine thousand ounces of the sul- phate—the form best known, and most frequently prescribed— were prepared. For this discovery, the Royal Academy of Sciences of Paris awarded MM. Pelletier and Caventou the Monthyon prize of ten thousand francs. Quinine is obtained from the yellow bark by a similar process to the one described for the separation of the cinchonine.2 In the pure state, it is of a white colour, and appears commonly in the form of powder; it crystallises, however, in silky, shining, tufted needles. In both cases, it contains from three to four per cent, of water. By a gentle heat, this escapes, and the quinine melts into a transparent fluid, which, on cooling, is translucent, and similar to a resin. When melted in vacuo, it has a crystalline appearance. In a strong heat, it is decomposed. It has a very bitter taste ; and is soluble in two hundred parts of boiling water; a portion being precipitated on cooling. It requires a much larger proportion of cold water to dissolve it. In alcohol, it is far more soluble than in water. It is, likewise, soluble in ether, and somewhat so in oils. It exhibits an alkaline reaction,—restoring the colour of reddened litmus paper, and neutralising the acids. 1 Annales de Chimie et de Physique, xv. 289 & 337. 3 See page 137. 376 NEW REMEDIES. The observations of Piorry and Lavollee1 and of Quevenne show, that the quinine, as well as its sulphate, passes into the urin< of patients who use it in any considerable quantity. EFFECTS ON THE ECONOMY. Of the effects of quinine we shall speak at some length, unde the head of sulphate of quinine, with which it seems to accon entirely in medicinal agency. Several physicians, who have ex perimented in regard to the efficacy of pure quinine and its salts have found the first in no respect inferior to the last. Such wa' the experience of Niewenhuis and Eliiotson, the latter of whom ex hibited the quinine in large doses—as much as five grains everj four hours. A French physician, Blegnie,3 even gives the prefer ence to the pure quinine—because it possesses, he thinks, equa efficacy, is cheaper, easier taken, and better borne than the sul phate. He advises, that after each dose an acidulous drink should be taken, to render its solution in the stomach more rapid. Wutzer and Harles5 have also recommended the more frequent use of pure quinine. It may be given either in the form of powder or pill, or in alco- holic solution. Tinctura Qjiinina. Tincture of Quinine. St. Q,uinin. 9j. Solve in alcohol, ^ss. Dose.—Twenty to forty drops every two hours. Wutzer. i Gazette Medicale, 1836, p. 73. 2 L'Experience, Juillet, 1S38. 3 Riecke, Die neuern Arzneimittel, S. 118. See, also, Bally, in Ma- gendie's Journal de Physiologie, ii. 236. * Isis, p. 441, 1829. 6 Heidelberg klinisch. Annalen, B. v. H. 4, S. 573. quinine acetas.—quinine citras. 377 QUININE ACETAS. Synonymes.—Chinium Aceticum, Acetas Chinii, Acetas Chinini, Acetas Chinicus, A. Quiniae, A. Quinae, A. Quinini, A. Quinii, A. Kinini, Ace- tate of Quinine. French.—Acetate de Quinine. German.—Essigsaures Chinin. This preparation has only recently been introduced into practice, but it is not much employed. It is prepared by saturating quinine with concentrated acetic acid diluted with water, and evaporating the neutral solution, by gentle heat, to crystallisation. It appears in the form of very delicate, needle-shaped, snow- white, satiny, and shining crystals ; tastes very bitter ; and is with difficulty soluble in cold water, but readily so in hot. Wutzer and Sundelin1 assert, that it acts like the other salts of quinine, but merits no preference. QUININE CITRAS. Synonymes.—Quinini Citras, Quiniae vef Quinae vel Quinii vel Chinini vel Kinini Citras, Citras Chinicus, Citrate of Quinine. French.—Citrate de Quinine. German.—Zitronsaures Chinin. MODE OF PREPARING. This preparation is formed, like the acetate of quinine, from an aqueous solution of citric acid and pure quinine, or by the decom- position of a hot solution of sulphate of quinine, by means of an acid citrate of soda.2 It forms needle-shaped prisms, of a white colour, which are by no means readily soluble in water. 1 Isis, p. 441, 1829: also, Heidelb. klinisch. Annal. B. v. H. 4. 575. 8 Guleani, in Annali Universali di Medicina, Luglio, 1832, and Heidelb. Klinisch. Annal. B. x. H. i. S. 34. Heidelb. 1834. 378 NEW REMEDIES. EFFECTS ON THE ECONOMY. The acetate and the citrate of quinine have been esteemed and are adapted for those excitable persons with whom the sulphate does not seem to agree. The citrate has been prescribed by many Italian physicians, and found to be very efficacious.1 Magendie considers it, when it contains an excess of acid, advisable for those cases, where the union of a tonic with an antiseptic property is in- dicated. He considers, that the following syrup may be substituted, in certain cases, for the syrupus antiscorbuticus.2 Syrupus Quinina Citratis. Syrup of Citrate of Quinine. St. Syrup, sacchar. clarif. ffij. Quinin. acetat. acid. gr. xxxvj. M. Dose.—Two spoonfuls in the twenty-four hours. QUININiE FERROCYANAS. Synonymes.—Chinium Ferrocyanogenatum, Ferrocyanas Chinii, &c. French.—Ferrocyanure de Quinine. German.—Eisenblausaures Chinin. METHOD OF PREPARING. This is obtained by the decomposition of sulphate of quinine by means of a solution of the ferrocyanate of potassa; after which the impure salt is treated with warm spirit of wine, and the clear solution is evaporated.3 1 Beraudi, in Bulletin General de Therapeutique, Nov. 1838. 2 This syrup is directed by the Codex Medicamentarius of Paris to be prepared in the following manner. Take of the fresh leaves of the coch- learia, water trefoil, cress, horseradish, and bittei oranges cut, of each one pound ; cinnamon, an ounce and a half, white wine, four pints. Macerate for two days in a tin cucurbit, covered with a well luted capital; Distil, in a sandbath, a pint of fluid ; to which add two pounds of white sugar, and make into a syrup. Pass through a cloth, without straining, what remains in the cucurbit; let the liquor rest, decant and boil to the consistence of syrup, with two pounds of white sugar. When cold, clarify and mix with the other. 3 See Bertozzi's Method, in Philad. Journ. of Pharmacy, vol. 2, new series, p. 82. Philad. 1837. QUININE MURIAS. 379 It forms needle-shaped, confused crystals, of a greenish yellow colour, and very bitter taste, recalling that of the hydrocyanic acid. It dissolves readily in spirit of wine, not so in water; and is de- composed by hot water. EFFECTS ON THE ECONOMY. In this combination, the antifebrile properties of the quinine are said to be even superior to those of the other preparations ; yet the remedy has not got into much use. It has been employed mainly by a few of the French practitioners. Cerioli,1 an Italian physi- cian speaks in high terms of its efficacy in periodical diseases, even where the sulphate has failed. He gave it in the dose of from two to eight grains, in the day; and Gouzee2 gives the history of three cases completely cured by the administration of a single grain, half an hour before the paroxysm. QUININiE MURIAS. Synonymes.—Chinium Muriaticum, Ch. Salitum seu Hydrochloricum, Hydrochloras Chinii, H. Chinicus. French.—Muriate de Quinine. German.—Salzsaures Chinin. Perhaps, next to the sulphate of quinine, this salt has most fre- quently been employed in practice. METHOD OF PREPARING. It is obtained by dissolving pure quinine in dilute muriatic acid, or by the decomposition of the sulphate of quinine dissolved in warm water by means of a solution of muriate of baryta, which is added so long as a white precipitate is thrown down ; the hot mixture is then filtered ; the precipitate washed, and the clear fluid evaporated, by a gentle heat, to crystallisation, so long as crystals shoot on cooling; these are collected, washed in cold water, and purified by repeated crystallisation. 1 Annali Universali di Medicina, Luglio, 1832, and Archives Generates de Medecine, Dec. 1832. 2 Observateur Medicale Beige, Jan. 1834. 380 NEW REMEDIES. It forms fine, needle-shaped, white, silky crystals, of a mother of pearl lustre; does not dissolve readily in water, but more so than the sulphate. EFFECTS ON THE ECONOMY. In this respect, the muriate agrees with the sulphate of quinine, and by those of weak digestive powers is better borne. Spiel man1 asserts, that it is a more speedy and effectual remedy for intermit- tent fever than the sulphate, and it is more soluble. It is, however, more expensive. The dose is generally considered to be the same as that of the sulphate. It is better given in solution than in powder. Spielman rates the dose at from half a grain to a grain. QUININE NITRAS. Synonymes.—Chinium Nitricum, Nitras Chinii, &c. Nitrate of Quinine. French.—Nitrate de Quinine. German.—Salpetersaures Chinin. METHOD OF PREPARING. This salt is obtained, like the muriate, by the addition of nitric acid to quinine; or by the decomposition of nitrate of baryta by sulphate of quinine. It is, at first, a fluid oil-like mass, which gradually becomes solid. In union with water, it forms crystals. It dissolves with difficulty in water, but readily in alcohol. 1 Allgemein. medicinisch. Zeitung, and Journal des Connais. Medic. Fevrier, 1836 ; see, also, Prof. Dierbach, in Heidelb. klinisch. Annal. B. x. H. i. S. 33. Heidelb. 1834. QUININiE PH0SPHAS.—QUININE SULPHAS. 381 QUININE PHOSPHAS. Synonymes.—Chinium Phosphoricum, Phosphas Chinii, Ph. Chinini, Phos- phate of Quinine. French.—Phosphate de Quinine. German.—Phosphorsaures Chinin. METHOD OF PREPARING. In the mode of preparation it accords with the preceding forms ; dilute phosphoric acid being added to quinine, or phosphate of ba- ryta, to the sulphate of quinine.1 It appears in the form of needle-shaped prisms, of a mother of pearl lustre, which are, like the muriate of quinine, readily soluble in water, and spirit of wine. Harles,2 however, affirms, that in the neutral condition it is soluble, with difficulty, in water. The phosphate is regarded by some to stand next to the sulphate in medicinal efficacy. QUININE SULPHAS. Synonymes.—Chinium Sulphuricum, Disulphas Quinas, Sulphas Chinii, Sulphas Quinicus, Sulphate of Quinine. French.—Sulfate de Quinine. German.—Schwefelsaures Chinin, Chininsulphat. This preparation of quinine is by far the most frequently admi- nistered. It is in fine, silky, flexible needles, and at times, in rect- angular columns. Its taste is extremely bitter and resembles that of yellow bark. Exposed to a moderate heat, it loses its crystalline form, in consequence of the escape of its water of crystallisation. It is only slightly soluble in cold water, requiring 470 parts of water at the ordinary temperature, and 30 parts of boiling water for its solution. In alcohol, it is very soluble, but only slightly so in ether. With sulphuric acid, it forms a supersulphate, which is 1 Winkler, in Biichner's Repert. and Philad. Journ. of Pharmacy, new series, vol. 2. p. 12. Philad. 1837. 2 Heidelb. klinisch. Annal. B. x. H. i. S. 36. Heidelb. 1834; and Journal de Chimie Medicale, 1837. 382 NEW REMEDIES. much more soluble in water than the neutral salt, and hence we usually add a few drops of dilute sulphuric acid to our mixtures of the sulphate of quinine. METHOD OF PREPARING. This salt is generally prepared on a large scale in the chemical laboratories of France ; whence we obtain it. A formula has been admitted, however, into the Pharmacopoeia of the United States, which is taken from the process of M. Henry, junr.,] for which he received a prize from the Academie Royale des Sciences, of Paris. It is as follows—Take of yellow bark, in powder, a pound ; lime, in powder, four ounces; sulphuric acid, alcohol, animal charcoal, distilled water, each a sufficient quantity. Boil the bark for half an hour with eight pints of the distilled water, acidulated with a fluid ounce of the sulphuric acid. Strain the decoction through linen ; then boil the residue with the same quantity of acidulated water, and filter as before. Mix the filtered liquors, and gradually add the lime, stirring constantly. Wash the precipitate with dis- tilled water, and having dried it, digest in alcohol with a moderate heat. Pour off the tincture, and repeat the digestion several times, till the alcohol is no longer rendered bitter. Mix the tinctures, and distil over the alcohol, till a brown viscid liquid remains in the retort. Upon this substance, removed from the retort, pour as much sulphuric acid, largely diluted with water, as may be suffi- cient for its perfect saturation. Then add the animal charcoal, and having evaporated the liquor sufficiently, filter it while hot, and set it aside to crystallise.3 It results from the calculations of Pelletier and Caventou, that from a quintal of cinchona, two pounds, one dram and thirty grains of sulphate of quinine may be obtained, which makes two drams, sixty-six grains and a sixth per pound, or thirteen grains and two sixths per ounce; and as the sulphate of quinine is com- posed of nine parts and nine tenths of sulphuric acid, to ninety and a tenth of quinine, it follows, that if the dose of cinchona in sub- stance be two drams, we should administer to the patient three grains and nine thirty secondths of a grain of the sulphate of qui- nine ; not taking into account a small quantity of sulphate of cin- chonine, which may be mixed with it. Four grains of the salt are, consequently, more than an equivalent for the dose of the cinchona 1 Journal de Pharmacie, vii. 296. Juillet, 1821. 2 Wood & Bache's Dispensatory, Art. Quinise Sulphas. GlUININvE SULPHAS. 383 often prescribed in substance. Those practitioners, therefore, who prescribe thirty-six or seventy-two grains of the sulphate, give the representative of about twenty-seven drams of cinchona in the former case, and of fifty-four in the latter.1 EFFECTS ON THE ECONOMY. The effects of the preparations of quinine on the healthy organism, have not been much investigated. According to Caventou, they produce a general excitement, similar to that caused by coffee, and Wittmann affirms, that the sulphate induces an excitement similar to that of a paroxysm of fever. Hirschel,2 too, asserts, that in a child, four years of age, to whom the sulphate was given in a case of intermittent, a general chilliness of some minutes' duration super- vened immediately on the taking of the remedy, succeeded, in the course of half an hour, by general heat, and this again by a gentle perspiration, in all respects resembling a mild attack of fever. The excitant action of the salts of quinine formed by the vege- table acids is said to be less striking. The sulphate of quinine, in large doses, appears, in some cases, to possess narcotic properties, yet it cannot be classed amongst poisons, as it has been given to healthy individuals in very large doses, without any unpleasant effects. Bally,3 for instance, gave it to the extent of 11.0 grains in the day without any inconvenience. Dr. Thomas Fearn,4 who administered it largely, regards it to be more narcotic than sedative,—usually, he thinks, stimulating in small doses, but in lar^e doses the stimulant effects not beinjr ob- vious, but rather the reverse. When Mr. Scott,* a medical gentleman and a martyr to dys- pepsia, took the quinine in very large doses, under the idea that his malady was intermittent neuralgia, he found several singular phenomena induced thereby. He was directed to commence with two grains three times a day, until he arrived at twenty grains for a dose, that is, a dram a day. Until the doses were increased to fourteen or sixteen grains, he did not experience any peculiar effects, but he now began to feel heat of skin, dryness of mouth and ' Jourdan's Pharmacopee Universelle, ii. 375. Paris, 1828. 2 Hufeland's Journal, B. lxi. St. 6. S. 140. 3 Rrvue Medicale, v. 214. Juillet, 1821. 4 Transylvania Journal of Medicine, Oct., Nov., and Dec. 1836, p. 708, and Amer. Med. Intell., June 15, 1837, p. 109. 5 Lond. Med. and Physical Journal, March, 1833. 384 NEW REMEDIES. fauces, and obstinate constipation. He likewise lost the power of naming substantives; was obliged for a long while to consider what familiar things were called, and was unable to cast up a line of six or eight figures correctly. His perceptions of quantity were likewise impaired, so that in prescriptions he wrote ounces for drams, drams for grains, (fee. . Secalis cornuti, §j. Aquae, Oijss. Coque ad Oij. et cola. Dose.—A table-spoonful every quarter of an hour. Tinctura Secalis Cornuti. Tincture of Ergot. St. Secalis cornuti, §ijss. Spirit, tenuioris, Oj. Macera per dies quatuordecim et cola. Dose.—Twenty mimims to two drams, two or three times a day, as a sedative agent. Guy's Hospital. Pulveres Secalis Cornuti Compositi. Compound Powders of Ergot. (Antihemorrhagic Powders.—Ryan.) St. Secalis cornuti, gss. Pulv. cinnam. comp. 9ss. Sacch. purif. £ss. M. et divide in chartulas x. SOD/E CHLORIDUM. 411 Dose.—One every hour or every second or third hour in active hemorrhage from any outlet. In leucorrhcea and gleet, one may be given three or four times a day, and should they fail the following may be substituted. St. Secalis cornuti, Qij. Pulv. cubebar. 3j. P. cinnam. c. 3ss. Sacchar. purif. gj. M. et divide in chartulas viij. Dose.—One, three or four times a day. Ryan. SOD.E CHLORIDUM. Synonymes.—Soda Chlorinata, Sodae Chloruretum, Chloruretum Oxidi Sodii, Sodae Oxymurias, Natrum Chloratum, N. Chloricum, N. Oxymuriati- cum, Chloride of Soda, Hypochlorite of Soda, Labarraque's disinfecting Liquid ; Chloruret of Soda, Chlorite of Soda, Chlorinated Soda. French.—Chlorure de Soude, Chlorure d'Oxide de Sodium. German.—Chlornatron. This preparation resembles in almost all respects the chloride of lime. (See Calcis Chloridum p. 83.) Both it and the chloride of potassa were associated by Berthollet under the common name Eau de Javelle, or bleaching liquor, and it has of late generally received the name of Liqueur de Labarraque. METHOD OF PREPARING. Labarraque1 recommended it to be prepared directly by passing a current of chlorine into a solution of subcarbonate of soda. The following is the formula, in the last London Pharmacopoeia, for the Liquor Soda Chlorinata, the Liquor Soda Chloridi, Aqua Natri Oxymuriatici, German, Oxydirt-salzsaures Natron- wasser, or Labarraque's disinfecting liquid. "Take of carbonate of soda, a pound ; distilled water forty-eight fluid ounces ; chloride of sodium, four ounces; binoxide of manganese, three ounces; sul- phuric acid, four ounces. Dissolve the carbonate of soda in two pints of the water; then put the chloride of sodium and binoxide of manganese, rubbed to powder, into a retort, and add to them the 1 Gazette de Sante, April 25, 1826. 412 NEW REMEDIES. sulphuric acid, previously mixed with three fluid ounces of water, and cooled. Heat, and transmit the chlorine first through five fluid ounces of water, and afterwards into the solution of carbonate of soda above directed." When the solution of chloride of soda is properly prepared, it has a yellow colour, a sharp, saline, and astringent taste, and an odour of chlorine. By careful evaporation, it yields crystals which produce the original liquid when re-dissolved. When the solution is exposed to air, and allowed to evaporate spontaneously, it gives out chlorine, and yields crystals of carbonate of soda.1 DEFECTS ON THE ECONOMY. In its general remedial agency, the chloride of soda resembles the chloride of lime, and has been administered both internally and ex- ternally in the same cases. It is preferred, however, for internal, whilst the chloride of lime is generally chosen for external, use. By Bouillaud, Chomel and others it has been given, with ad- vantage, in typhous fevers; and by Kretschmar,2 Lalesque, Colson, and Gouzee3 in intermittents :4 ten cases are reported by the last named gentleman ; in two, the intermittent yielded immediately; two others were cured after a slight return ; in one there were four attacks, gradually diminishing; in two cases, the severity of the paroxysms abated, but it was thought necessary to have recourse to the sulphate of quinine; in two others, no effect was produced, and in one, the disease was aggravated. Gouzee infers, that these cases prove the febrifuge properties of the chloride of soda to be less marked that those of the sulphate of quinine, and, therefore, that it ought not to be trusted to, except in the slighter cases, and where the patients are easily susceptible of the effects of medicine,—as women and children. In like manner, it has been found useful in scrofulous affections, and in various diseases in which the chloride of lime has proved serviceable. See Calcis chloridum. 1 Faraday, Quarterly Journal of Science, N. S. ii. 84, cited by Brande, Dictionary of the Materia Medica, p. 508, Lond. 1839. 2 Venus, Grundriss der medicin. Receptirkunst, S. 67. Weimar, 1838. 3 Revue Medicale, Fevrier, 1836. 1 Riecke, Die neuern Arzneimittel, S. 334. SPILANTHUS OLERACEUS. 413 MODE OF ADMINISTERING. From ten drops to a dram may be given internally for a dose, mixed with plain or sugared water. The form in which it was prescribed by Gouzee, in inter- mittents, was a mixture, composed of half a dram of the chloride to four ounces of distilled water. This was taken by spoonfuls during the apyrexia; so that the last dose should be swallowed shortly before the next paroxysm was expected. The patients were restricted to their beds, or at least to their chambers. When applied externally, it is rarely used pure or diluted with so little as one half water, except in cases of asphyxia, and gan- grene, and for dressing old ulcers, Tic douloureaux. ° ( permanent ^ 2 Spasms < ) EPi,ePsy- ' rf . . < including > St. Vitus's Dance. 3. Convulsions J \ *r ■ ( ) Hysterics. 4. Cramp. 5. Brow-ague. 6. Tetanus or lock-jaw. 7. Highly acute toothach. 8. Nervous headach. B. Principally affecting the Muscles and Tendinous Tissues. 9. Rheumatism. 10. Lumbago. 11. Swelled and highly painful articulations. C. Principally affecting the Circulation. 12. Headach from fulness of blood in the head. 13. Congestions and sudden attacks of blood in the head. 14. Sore throat. 1 Lancet, Oct. 27, 1838. CONTRA-IRR1TATIO. 471 15. Early in- j rt" of the trachea and bronchia. 1 Tend»ng flammation. f b' of the lungs and their membranes. \ to c. of the heart and pericardium. | Oonsump- J r J tion. D. Diseases of a Mixed Character. 16. Suppressed gout, i a' A£ect.inS the heart. S b. Affecting the stomach. 17. Genuine gout. 18. Paralytic debility. E. Accidental, Mechanical, and Cutaneous Derangements. 19. Violent sprains. 20. Pimples. 21. Biles. 22. The ringworm." Dr. Granville does not affirm, that all these disorders, and their modi- fications, have yielded to the ammoniated counter-irritants ; or that the counter-irritants were always the sole agents employed. On the con- trary, a few of them, he says, on particular occasions, resisted that agency ; others were only momentarily benefited ; and a few more re- quired the simultaneous employment of ordinary and internal remedies to assist in, and complete, the cure. Among the exceptions to the general rule of success, he enumerates chronic tic douloureux; chronic rheumatism of long standing; epilepsy, dependent on organic mischief in the brain, or any part of the spinal apparatus; and rheumatic gout, in persons whose constitutions had been completely shaken by that disorder, or by any other previous disease, although, even in this case, some good was obtained from using the am- moniated counter-irritants. The second and fourth of these disorders are of that number which require, in addition to the ammoniated appli- cations, an appropriate internal treatment. The other two, Dr. Gran- ville has found to be only partially relieved, but never cured by counter- irritating lotions.1 In many of the disorders, referred to by Dr. Granville in the table given above, his ammoniated counter-irritants have been employed both in public and private in this country, and especially, perhaps, in this city. The effect in nervous and spasmodic diseases, in neuralgic and deep-seated rheumatic pains, has at times been very striking. Severe pains have yielded rapidly, as described by Dr. Granville ; hyperaemiae of particular organs have been diverted elsewhere, especially after blood- letting and sedatives had been premised ; and, in short, whenever revel- 1 Op. cit. p. 29. 472 NEW REMEDIES.--SUPPLEMENT. lents, sudden and rapid in their action, have been demanded, the ammo- niated counter-irritants have effected every thing that similar powerful revellents were capable of accomplishing,—but no more. We are in the habit of having recourse to the moxa in congenerous affections, and—as we have before remarked—with equally satisfactory results. There is one objection, too, that applies to the use of these strong lotions;—the sloughs and sores induced by them are often considerable, and remarkably difficult to heal. This, it is true, may be partly pre- vented, by being careful that the application is not too long continued ; but, with the greatest caution, these results will, at times, supervene. When such is the case, simple dressings, with emollient poultices, will be found the best applications. 2. MOXA. Svnonyme.—Moxiburium. By the term moxa, the Chinese and Japanese designate a cottony sub- stance, which they prepare by beating the dried leaves of the artemisia chinensis, a kind of mugwort. With this down they form a cone, which is placed upon the part intended to be cauterised, and is set fire to at the top. This mode of exciting counter-irritation has been long practised by the Chinese and Japanese, and by the ruder nations of the old world ; but it was not much employed in Great Britain and France until about the commencement of the seventeenth century, when it was introduced through the agency of a physician1 who had resided in India. It fell again, however, into disuse, until attention was redirected to it, during the last century, by Pouteau3 and Dujardin, and, at the commencement of this century, by Percy and Laurent,3 Larrey and others.4 MODE OF PREPARING. Various agents have been used by different people, in " moxibustion,"— for so the mode of cauterisation has been termed, which consists in placing some combustible substance on a part of the body, and suffering it to burn down. From the earliest ages, the Nomades employed the 1 Ten Rhyne, Medit. de veteri Medicin.; Dissert, de Arthritide, Lugd. Bat. 1672; and Kasmpfer's History of Japan, translated by Scheuchzer, vol. ii. .append, sect. iv. Lond. 1728. 2 Melanges de Chirurgie, p. 49. 3 Dictionnaire des Sciences Medicales, Art. Moxibustion. 4 See, for a history of the moxa, the author's translation of Baron Larrey's Memoir on the use of the Moxa. Lond. 1822. MOXA. 473 fat wool of their flocks, as well as certain spongy substances growing upon oaks,1 or springing from the hazel ;2 the Indian the pith of the reed,3 and flax or hemp impregnated with some combustible material ;4 the Persian, the dung of the goat; the Armenian, the agaric of the oak; the Chinese and Japanese, the down of the artemisia; the Thessalian, dried moss ;s the Egyptians, the Arracanese, and several oriental nations, cotton ;° the Ostiaks7 and the Laplanders,3 the agaric of the birch ; and the aborigines of this continent, rotten and dried wood. Hippocrates9 was in the habit of employing fungi and flax for the same purpose. In modern times, also, various substances have been used for the fabrication of the moxas. Whatever article is selected, it ought to be a spongy, light, vegetable matter; readily combustible, and so prepared as to burn down slowly. In Germany, they use the tinder—amadou— which is known to be an agaric prepared for the purpose; and it is not uncommonly employed in our hospitals,—a small disc or cylinder being placed on the part, and set fire to. The match used by artillerists was recommended by Percy,10 after Bontius:" it is composed of hemp steeped in a solution of nitre. He likewise proposed the pith of the sun- flower—helianthus annuus—recommending, that the stalk should be cut into cylinders of the desired length, the bark being left on ; so that, when ignited, it may burn in the centre and be held with the hand.13 This, he calls moxa de voleurs.13 The moxa, used by Larrey, and very generally employed by many practitioners, is made by taking a quantity of cotton wool, pressing it somewhat closely together, and rolling over it a piece of fine linen, which is fastened at the side by a few stitches. Larrey advises, that it should have the shape of a truncated cone—the form usually adopted—and be about an inch long. Commonly the cylinder is shorter than this; six or eight lines— as, when above six lines high, the combustion is not felt—and about four or five lines broad. The moxas, employed by Dr. 1 Hippoc. lib. de Affect, cap. xxx. 2 Paulus iEginet. lib. vi. cap. 49. 3 Kcempfer, vol. ii. app. sect. iv. p. 36. 4 Bontius de Medicina Indorum, p. 32. 6 Percy, in Pyrotechnie Chirurgicale pratique, p. 12. 6 Prosper. Alpin. de Medicina iEgyptiorum, lib. iii. cap. 12. 7 Voyages de M. Pallas, iv. 68. 8 Acerbi's Travels through Sweden, Finland, and Lapland, ii. 291, and Linnaeus, in Lachesis Lapponica, translated by Sir James Smith, i. 274. 9 De Affect, cap. viii. 10 Op. cit. p. 77. Paris, 1811. 11 Op. cit. p. 32. Paris, 1645. 12 Art. Moxibustion, in Diet, des Sciences Medicales. 13 Merat & De Lens, Diet, de Mat. Med., Art. Moxa. 00 474 NEAV REMEDIES.—SUPPLEMENT. Sadler,1 of St. Petersburg, are about half an inch in diameter, and three quarters of an inch in height. They are composed of a nucleus formed of the pith of the sunflower, wrapped in layers of cotton, of various thickness, and surrounded with an external envelope of thin muslin; both of the latter being previously steeped in a solution of nitre. They are held, while burning, by means of two long hair pins, the legs of which are slightly bent, in order to accommodate them to the shape of the moxa; and, when the latter is burned down to the place where it is held by the first hair-pin, it can be held with the other, and retained in its proper position. With this last view, Larrey2 has a special porte-moxa, consisting of a ring to receive the cylinder, with a handle attached to it, and three small supports or knobs of ebony, placed beneath the ring, to prevent the heated metal from acting upon the surface. Of late years, a plan for raising vesication on the surface has been adopted, which, as Dr. Granville remarks, must be regarded as a kind of moxa.3 This, he admits, is equally successful with the one he proposes, and which we have already described, (p. 396,) in forming a rapid vesi- cation ; " but it is, at the same time, so complicated, and attended by such intense pain," that, in practice, he says, it will not bear comparison with the preparations which he recommends. A piece of linen or paper, being cut of the requisite size, is immersed in spirit of wine, or brandy. It is then laid on the part to be blistered, care being taken that the moisture from the paper or linen does not wet the surrounding surface. The flame of a lighted taper is applied quickly over the surface, so as to produce a general ignition, which is exceedingly rapid. At the con- clusion of this operation, the cuticle is found detached from the true skin beneath. In the application of the various moxas, or of most of them, their agency can be so graduated as to produce either simple rubefaction, vesi- cation or the formation of an eschar. Where it is desirable to produce the first result only, the cylinder of cotton may be removed when the pain becomes somewhat severe; or the burning material may be held close to the surface, and be moved gradually along it. In this manner, a counter-irritant effect may be exerted along the spine or any extensive surface. Any burning substance—a lighted coal for example—will answer for this purpose. When vesication is needed, it must be kept on longer ; and if it be desirable to produce an eschar, the moxa may have to remain on until it is wholly consumed. Larrey,4 indeed, 1 Zeitschrift fur die gesammte Medicin. B. iii. H. ii. ife iii. and British and Foreign Medical Review, July, 1837, p. 217. 2 The author's translation of his Essay on the Moxa, p. 5. 3 Counter-irritation, its Principles and Practice, Amer. Med. Library edit. p. 21 and p. 42. Philad. 1838. 4 Op. citat. p. 5. GALVANISMUS. 475 advises, that the blowpipe should be occasionally employed to hasten the combustion. When the integument has once become disorganised, the slough will be thrown off in due time, leaving an ulcer. Larrey says the sloughing can be prevented by the application of liquid ammonia1 to the burnt surface, after the moxa has been removed. This will do when the disorganisation is partial; but we know, from experience, that it often fails. EFFECTS ON THE ECONOMY IN DISEASE. The moxa—in its different forms—is doubtless a most valuable agent, where rapid counter-irritation is indicated. It resembles, indeed, in its action, the ammoniated counter-irritants of which we have already treated, and is applicable to the same diseases;—the only difference between them—when cauterisation is effected—being, that the agent in the case of the ammoniated lotion is a potential, in that of the moxa an actual, cauterant. The moxa must be regarded as one of our most valuable revellents. III.--GALVANISMUS. Synonymes.—Galvanism, Electricitas Animalis, E. Galvanica seu Metal- lica, Irritamentum Metallorum seu Metallicum. French.—Galvanisme. The ordinary effects of common and galvanic electricity and of electro-magnetism are so well known, as to require but little com- ment. They are decidedly excitant; and, like all excitants, when applied to a part of the frame, are counter-irritant or revellent. All have been employed in paralysis—general and local,—amaurosis, deafness and dumbness of recent duration, asthma, rheumatism, neu- ralgia, &c. The effect, however, which galvanism exerts on the con- tractility of the muscular fibre, and the great similarity, in its agency, to the nervous influence,2 has led to its employment more frequently in the various nervous and spasmodic diseases referred to, and in others belonging to the same class. Resting on his views of the absolute identity between the nervous and the galvanic fluids,3 Dr. Wilson Philip employed it in many diseases, and especially in asthma. In a paper read by him before the Royal Society of London, in Janu- ary 1816, he details some experiments, which he made on rabbits. ' Ibid. p. 9. 2 See the author's Physiology, i. 88, 3d edit. Philad. 1838. 3 Experimental Inquiry into the Laws of the Vital Functions, Lond. 1817. 476 NEW REMEDIES.--SUPPLEMENT. The eighth pair or pneumogastric nerves were divided by incisions made in the neck. After the operation, the parsley, which the animals had eaten, remained unchanged in their stomachs, and after evincing much difficulty of breathing they seemed to die of suffocation. But when, on ether animals, whose nerves had been divided, the galvanic agency was transmitted along the nerve, below its section, to a disc of silver, placed closely in contact with the skin of the animal, opposite to its stomach, no difficulty of breathing occurred. The galvanic action being kept up for twenty-six hours, the rabbits were then killed and the parsley was found digested. The removal of dyspnoea in these cases led Dr. Philip to employ gal- vanism as a remedy for asthma; and, by transmitting its influence from the nape of the neck to the pit of the stomach, he gave decided relief in every one of twenty-two cases, of which four were in private practice, and eighteen in the Worcester infirmary. The power employed varied from ten to twenty-five pairs of plates. Since then, galvanism has been repeatedly used in such cases, and at times with marked relief. Com- monly, however, the plates, described hereafter, are employed for this purpose. The disease is unquestionably in the majority of cases dependent upon erethism of the pneumogastric nerves ; all the phenomena indicate, that there is a spastic constriction of the small bronchial tubes, occasioned by irritation at the extremities or in the course of the nerve. The new impression, made by the galvanic agency, breaks in upon the concentration of nervous action, by exciting other portions of the nervous system, in the same manner as we observe spasms or ordinary cramp relieved, or paroxysmal diseases warded off, by agents that are capable of suddenly impressing some part of the nervous system. Not long after these researches of Dr. Philip, galvanism was employed satisfactorily by Mr. Mansford1 in a congenerous disease—epilepsy—and his plan was afterwards—although tardily—extended to some other paroxysmal disorders. The mode of application, recommended by Mansford, is as follows : A portion of the cuticle, of the size of a sixpence, is removed by means of a small blister on the back of the neck, as close to the root of the hair as possible; and a similar portion is removed from the hollow, beneath, and on the inside of, the knee, as the most convenient place. To the excoriated surface on the neck, a plate of silver, varying—according to the age of the patient—from the size of a sixpence to that of a half crown, is applied, having attached to its back part a handle or shank, and to its lower edge—and parallel with the shank—a small staple, to which the conducting wire is fastened. This wire passes down the back, until it reaches a belt of chamois leather, buttoned round the waist; it then ' Researches into the nature and causes of Epilepsy, &c, Bath, 1819. GALVANISMUS. 477 follows the course of the belt to which it is attached, until it arrives oppo- site the groin of the side on which we desire to employ it; it then passes down the inside of the thigh, and is fastened to the zinc plate in the same manner as to the silver one. The apparatus, contrived in this way, is thus applied. A small piece of sponge, moistened in water, and corresponding in size to the blistered part of the neck, is first placed directly upon it; over this, a large piece of the same size as the metallic plate, also moistened, is laid, and next to this, the plate itself, which is secured in its situation by a strip of adhesive plaster passed through the shank in its back ; another above, and another below it. If these be properly placed, and the wire, which passes down the back be allowed sufficient room that it may not drag, the plate will not be moved from its position by any ordinary motion of the body. The zinc plate is fastened in the same manner, but in place of the second layer of sponge, a piece of muscle answering in size to the zinc plate is interposed ; that is—a small piece of moistened sponge being first fitted to the exposed surface below the knee, the piece of muscle moistened, or—what we have found equally effectual and less inconvenient—a piece of moistened flannel1 follows, and on this the plate of zinc. The apparatus, thus arranged, will continue, according to Mr. Mans- ford, in gentle and uninterrupted action from twelve to twenty-four hours, according to circumstances. " This last is the longest period that it can be allowed to go unremoved ; the sores require cleaning and dressing, and the surface of the zinc becomes covered with a thick oxide, which must be removed to restore its freedom of action: this may be done by scraping or polishing; but it will be better if removed twice a day, both for the greater security of a permanent action, and for the additional comfort of the patient." The adoption of this plan of treatment in cases of tic douloureux, the confidence reposed by Laennec in the use of galvanic plates on the breast and back in angina pectoris and similar neuralgic affections of the chest, and the communications of Drs. Harris and Chapman, brought it into very extensive use, so that ample trial was given to it in this country both in public and private practice. In three cases, it was—to employ the Ian- guage of Professor Chapman3—" triumphantly directed" by Dr. Harris; but it was only found effectual in affections of the face; and in these cases it had to be persevered in for some time before marked benefit was experienced.3 About the same period, this mode of applying galvanism was recommended by Dr. Miller,4 of Washington University, Baltimore, 1 Dr. Chapman says soft buckskin or parchment. American Journal of the Medical Sciences, Aug. 1834, p. 311. 2 Op. citat. p. 311. 3 Dr. Harris, in Amei. Journal of the Medical Sciences, Aug. 1831, p. 384. 4 Ibid. p. 321. 478 NEW REMEDIES.--SUPPLEMENT. and a case of paraplegia and another of general paralysis were adduced by him in which it was found highly efficacious. There are doubtless—as we have observed—cases in which the exci- tant and revulsive agency of galvanism may be employed with advantage, but they are not so numerous as was at one time believed. We have used the plates extensively—in neuralgic cases especially—but have not experienced so much success, as to induce us to advise them frequently, under the inconvenience that necessarily accompanies their employment. They are, indeed, at this time, but little used. Some years ago, Professor Von Hildenbrand, of Pavia,1 recommended, in cases of frontal neuralgia, an anodyne metallic or galvanic brush, which appears to have been as effectual in his hands as the galvanic plates in those of Dr. Harris. It consists of a bundle of metallic wires not thicker than common knitting needles, firmly tied together by wire of the same material, so as to form a cylinder of about four or five inches long, and an inch or three fourths of an inch in diameter. This is applied to the pained part, previously moistened with a solution of common salt; and, according to Von Hildenbrand, it at times produces relief so instantaneous, that it appears to the patients to act like a charm. In his first experiments, he employed brushes constructed of two kinds of metal,—for instance, of silver and copper wire, copper and zinc wire, or *► zinc and brass wire, the individual wires being mutually commingled ; but he subsequently ascertained, that bundles of wires of one and the same metal produced an effect scarcely less speedy, and that solid metallic bodies acted in a similar manner, but in a much feebler degree. The nature of the metal he thinks occasions no difference. It is not probable, however, that, in these cases, galvanism is the agency concerned. Like the metallic tractors of Perkins, the effect is probably induced by the new nervous impression made through the excited imagination of the patient. Animal Magnetism—Mesmerism, Neurogamia, Biogamia, Biomag- netismus, Zoomagnetismus, Tellurismus, Exoneurism, as it has been termed—exerts an anodyne influence in probably the same manner. In highly impressible persons, more or less prolonged impressions made upon the senses—as by the operator looking steadfastly in the eyes of the patient, holding her thumbs or hands in his at the same time, or making passes in front of her—will induce an hysteric or hysteroid condition, in which the patient may fall into what is called " magnetic sleep," of a very sound, and at times cataleptic, character: during the existence of this sleep, she may be insensible to certain irritants, and yet extremely alive to others, so that operations—as the extraction of teeth, and even some of a more serious character—may be performed without eliciting 1 Edinburgh Medical and Surgical Journal, April, 1833. INJECTIONS INTO THE EUSTACHIAN TUBE. 479 the ordinary evidences of feeling. In cases of delirium tremens, accom- panied by watchfulness, in which we have the whole nervous system extremely impressible, sleep may be at times induced by the employ- ment of this agency, which has resisted the ordinary anodynes.' Lastly. Of late years, it has been proposed to introduce into the rectum, in cases of constipation, a kind of galvanic suppository, made of two metals—zinc and copper—and various forms of instruments have been devised by the prolific imaginations of the inventors ; those intended for the rectum simply, were doubtless of advantage, at times, by virtue of the excitation they induced in the nerves of the mucous membrane. Others, formed somewhat like a bassoon—and so arranged as to have one metal in the mouth and the other in the rectum connected together by metal—did not appear to act differently from those of the simpler form. Both have gone into disuse, and—as we have said elsewhere2—if their efficacy on the frame has not been well marked, they have not failed to minister to the pockets of their inventors. III. INJECTIONS OF AIR, VAPOUR OF ETHER, &c. INTO THE EUSTACHIAN TUBE. An important improvement, in the understanding and treatment of diseases of the ear, has resulted from the attention that has been paid, of late, to the pathological condition of the Eustachian tube, and the means through it of rectifying certain morbid states of the organ of hearing. A mystery has been thrown, or attempted to be thrown, over the diseases of the ear, and as a consequence, they have furnished largely to empiricism ; so that an eKclusive aurist has been, too often, perhaps, esteemed synonymous with an exclusive empiric. Now, that the phy- siology of the outer and middle ear is better understood, their patholo- gical relations are no longer environed with the same difficulties. The attention of the surgeon has to be first directed to the meatus externus, and if he discovers any obstacle,—as hardened cerumen,—which prevents the vibrations of a sonorous body from reaching the membrana tympani, such obstacle must be removed. If no defect exists there, he inquires into the state of the Eustachian tube, to detect, whether it be pervious so as to permit a free passage for the air from the throat to the middle ear—ariy impediment to which is a common cause of deafness; and, lastly, if the tube is found in a state of integrity, his attention is turned to the condition of the nerve, to discover whether the defect—organic or func- 1 Dr. Vedder, in American Medical Intelligencer, Feb. 1, 1839, p. 331. 2 General Therapeutics, p. 248, Philad. 1836. 480 NEW REMEDIES.--SUPPLEMENT. tional—be seated there. Such are the main subjects of inquiry in cases of deafness; although the condition of the membrana tympani, of the ossicles, and the mastoid cells become interesting incidental objects of inquiry. Chronic inflammation of the Eustachian tube occasionally gives rise to stricture or narrowness of the tube ; and, at others, to obstruction of the tube by means of mucus, or to accumulation of mucus in the tympanic cavities. In the former case, catheterism is demanded; in the latter, injections of air, in addition. For the purpose of catheterism, various instruments have been em- ployed. The catheter of Itard is a conical silver tube, curved at the extremity, with a slight enlargement to prevent laceration of the mem- brane. Kramer's instrument is a modification of that of Itard ; the curve is more gradual, and the enlarged or button point is omitted. It is made of silver, six inches long, and of a calibre varying from the size of a small crow-quill to that of a large goose-quill. The extremity is well rounded, and it is curved, only to the distance of five lines from the point, exactly at an angle of 144°, so as to correspond with the lateral situ- (Reduced one half.) ation of the mouth of the Eustachian tube. It is of the same calibre throughout its whole length, and provided with a funnel-shaped dila- tation at the outer extremity, half an inch in length, to admit the pipe of the injecting syringe, &c. To this part is attached a ring, on the same level with the beak of the catheter, by means of which the situation of the beak can be ascertained, when the instrument is intro- duced. The catheter is farther graduated in inches, which is convenient in repeated introductions.1 When it is requisite to sound the Eustachian tube, a piece of catgut may be passed through the instrument. The catheter recommended recently by Mr. Pilcher3 admits of being passed farther into the tube, and has a more gradual curve. Deleau employs a flexible elastic gum catheter, which the patient 1 Kramer, on Diseases of the Ear, chap. 2, Amer. Med. Library Edit. Philad. 1838. 2 A Treatise on the Structure, Economy and Diseases of the Ear, p. 304, Lond. 1838. 3 Op. cit. p. 305. INJECTIONS INTO THE EUSTACHIAN TUBE. 481 learns readily to pass into the Eustachian tube, and, by turning down the outer extremity, is able to inflate the tube with his own breath. This we have seen done repeatedly. The silver instrument being slightly warmed and oiled, is introduced, with its convexity upwards, along the floor of the nostrils until the point reaches the pharynx ; it is then gently turned, so that the point shall be outwards and a little upwards, the aperture of the Eustachian tube being above the level of the floor of the nose; in this way, the tube enters, and is readily felt by the operator to have done so. The instrument is then carried onwards, until its farther progress is prevented by the narrowness of the tube. Mr. Pilcher's instrument is of such dimensions as to frequently occupy three quarters of an inch of the tube; but if it be pushed beyond the fibro-cartilaginous portion—or that part of the tube, which readily admits it—the mucous membrane may be lacerated, and pain will cer- tainly be produced.1 When Mr. Pilcher's catheter is fairly introduced, it will remain with- out support, an advantage it possesses—in the opinion of its proposer— over those of Itard and Kramer, which require a frontal bandage to retain them in situ. Itard's is represented in the accompanying figure. It consists of a middle piece made of metal, bent so as to fit the arch of the forehead, and slightly padded within ; to this are attached two straps, which fasten with a buckle. To the centre of the middle piece, a pair of forceps are attached, which move in a ball and socket joint, and the blades of which are brought together by a screw. The bandage is applied, before the catheterism is commenced; and when the instrument is introduced, the forceps are brought down, and screwed tight on the catheter, so as to retain it in position. Through the catheter, thus introduced, aurists were in the habit of introducing lukewarm water through the Eustachian tube into the cavity of the tympanum ; but owing to certain objections that apply to the employment of fluids, Deleau2 suggested the air-douche or injections of 1 Op. cit. p. 305. 2 Sur le Catheterisme de la trorape d'Eustache, &c, Paris, 1828; Itard in Mem. de l'Academ. Royale de Medecine, Tom. v. Fasc. 4, Paris, 1836; and translation in Medical and Surgical Monagraphs, vol. 1, p. 75, of Amer. Med. Library, p. 8G, Philad. 1838. 61 482 NEW REMEDIES.—SUPPLEMENT. air for the purpose of clearing the cavity; and this is regarded by Kramer1 as a great improvement. With the view of increasing and regulating the force with which the air is sent into the cavity, both these gentlemen invented air-pressers or condensers. The figure beneath represents that of Kramer. c b is a cylinder, 104 inches high, made of molten brass; the diameter of its calibre is 4£ inches, and it is fastened at & with strong screws, on a strong oaken stand of the height of an ordinary stool. Within the cylinder c b is a pump barrel of wrought brass screwed into it, which measures 10J inches in height, and 2£ inches in diameter, rising at d a 3 inches out of the cylinder, so that the whole machine a 6 is about 13 inches high. In the piston of the pump barrel, there is a valve for the passage of the air, which besides passes in at the opening situate at d. There is a second valve in the bottom of the pump barrel, through which the air is forced into the interior of the cylinder. When air is injected into the tympanum, it may be heard to strike against the membrane, and to rush through the cavity into the mastoid cells, and thus may become a means of exploring the condition of the middle ear. Mr. Pilcher,2 however, observes, that from his daily experience of the great facility with which air and fluids may be introduced into the tym- panum, and regulated, both as to quantity and force, by means of a com- mon syringe accurately fitted to the catheter, he does not hesitate to declare his conviction, that the ceremony and inconvenience of the air-press may be dispensed with. He recommends that the operator should merely steady the instrument with his left hand, whilst he uses the syringe with his right. By this means, any fluid or gas injected through the catheter, 1 Op. citat. p. 164. 2 Op. cit. p. 307. INJECTIONS INTO THE EUSTACHIAN TUBE. 483 may be brought in contact with the mucous membrane, and thus stimu- late the nerves of the cavity. Nor is the air-press entirely devoid of danger. Very recently, a case has been detailed in which, after " pumping air" four times through the nostrils into the Eustachian tube, immediately on removing the instru- ment from the nostril, the patient fell back in the chair and never spoke afterwards.1 The sudden shock to the nervous system was probably the cause of death ; and it has been suggested, that to avoid too great a degree of pressure, the nozzle of the tube of the air-press should be held during the operation so loosely in the dilated end of the catheter, that there may be room for air to regurgitate;2 and likewise, that instead of sending in the air by douches or charges—it should be transmitted in a gentle and continued stream. Another circumstance, which shows the importance of care, is the fact, that the mucous membrane may be ruptured, and serious emphyse- matous tumefaction be occasioned. It is proper, moreover, to observe, that the results of 258 cases, treated by Itard3, are far from encouraging. Of these, but two cases of cure are said to have been effected, and in this result, according to Itard, other causes concurred; whence he infers, first, that as a means of exploring obstructions of the tympanum by the crepitation, which often accom- panies them, douches of air can afford no certain index ; and secondly, that as a mechanical agent for deterging or evacuating obstructing matters, thev can only dislodge and force them together; and, consequently, that both in the second and first point of view, douches of air do not deserve the confidence of the profession.4 The vapour of acetous ether has recently been injected into the middle ear, in cases of nervous deafness, of which Kramer5 makes two varieties, noise in the ear constituting the essential point of difference between them. The noise in the ear belongs, without exception, to the erethitic form, whilst it is foreign to the torpid. In cases of nervous deafness, Itard proposed to introduce ethereous vapour through the catheter, and to gene- rate this vapour in an apparatus, in which the ether is dropped on a saucer of red hot iron, by the heat of which it is vapourised. The ether is, how- ever, decomposed in this manner, so that it is not ethereous vapour, which enters the tympanum, but an acrid very irritating kind of gas, which, 1 London Med. Gazette, July 6, 1839, p. 538, and American Medical Intel- ligencer, Aug. 15, 1839, p. 150. 2 British and Foreign Medical Review, July, 1839, p. 95. 3 Op. citat. «See, on this subject, Mr. T. Wharton Jones, in Lond. Med. Gaz., Aug. 3 & 10, 1839. o Op. citat. 211 484 NEW REMEDIES.--SUPPLEMENT. according to Kramer, is well suited to the torpid form of nervous deaf- ness, but is positively injurious in the erethitic variety. He considers the attempt to vapourise acetous ether in a flask, placed in warm water, and connected by means of a tube with the cavity of the tympanum, to belong to the same class of methods, which act in too irritating and inju- rious a manner, owing to the vapour being given off far too rapidly. This inconvenience he proposes to remedy, in the erethitic form of nervous deafness, in the following way. A large glass flask—represented in the accompanying figure—holding about ten quarts is firmly and closely slopped with a cork through which are passed two brass tubes, each provided with a cock; one of these tubes is connected above with a funnel for dropping in the fluid, and the other with an air-tight tube to conduct the vapour, generated and inclosed within the flask, into the cavity of the tympanum. When the apparatus is to be used, the cork is to be firmly fixed into the neck of the flask, with the two tubes attached, and the cocks closed; the proper quantity of ether is then to be poured into the funnel, and forced into the flask by a gentle expiration, where it is converted into thin vapour at the ordinary temperature of the room. This vapour fills the interior of the flask equably,-and is, indeed, in a state of slight condensation, so that when the metallic tip of the tube is connected with the catheter, and the cock is opened, the vapour issues with a whizzing sound. Having previously introduced the catheter, through the nose, into the mouth of the Eustachian tube, and placed it in connection with the tube INJECTIONS INTO THE EUSTACHIAN TUBE. 485 of the vapour apparatus, the patient is to sit near a table, and leaning his arm upon it, with the corresponding hand he is to hold the tube of the apparatus, in such a manner that it may remain in close connection with the catheter. Each sitting occupies a quarter of an hour, and is repeated daily, applying the vapour alternately to the right and to the left ear. It is unnecessary to make use of warm water to pour into the flask, as the ordinary temperature of the room is sufficient to vapourise the ether. In the torpid form of nervous deafness this method of procedure does not answer, owing to the necessity of greater excitement than it is capa- ble of effecting. In such case, a modification of the apparatus of Itard has been proposed by Kramer. In consequence of the metallic saucer in Itard's becoming cool more than once during a single sitting, and re- quiring to be exchanged for a hot one; as a necessary consequence the temperature of the vapour generated never remains, for a moment, the same, but varies extremely; immediately after the insertion of the red- hot saucer, the vapour issues burning hot into the ear, and, in a few minutes sinks to a very low temperature. These evils Kramer proposes to rectify in the following manner. The floor on which the bell-glass of the apparatus rests is substituted by a thin metal plate, which is warmed, at pleasure, by an oil lamp placed beneath, so that the ethereous fluid falling on it is thus conducted through the catheter into the middle ear. Through the cover of the apparatus, a thermometer, with a metallic scale, passes down almost to the bottom, and indicates the temperature at which the ethereous vapour passes into the ear. After a sitting or two—if the individual is to be benefited by the plan in either form of deafness, an improvement ought to be perceptible. This course of tivatmef;:, aided, occasionally, by attention to the state 486 NEW REMEDIES.--SUPPLEMENT. of the system, has, in Kramer's hands, been attended with satisfactory results, and has been adopted with advantage by others with a more or less modified apparatus.1 The only published case, in this country, of the successful application of the acetous ether in erethitic deafness, is by Dr. Bolton, of Rich- mond, Virginia.2 The hearing distance was amazingly improved by it, and the success far exceeded the operator's most sanguine expectations. The vapour proves, however, at times too irritating, or occasions results by no means to be desired. The Author was applied to in one case in consequence of inflammation having supervened in the mucous membrane, which subsequently extended, in the erysipelatous form, over the cutaneous surface. It yielded, however, to appropriate treat- ment. 1 Pilcher, Op. cit. p. 318. 2 American Medical Intelligencer, April 1, 1839, p. 1. INDEX OF NEW REMEDIES. Acetum ligneum, 18. Acid, auric, 79. Hydriodic, liquid, 301. Hydrocyanic, 1. Hydrocyanic, medi- cinal, 1, 13. Lactic, 15. Of milk, 15. Oxymuriatic, liquid, 130. Prussic, 1. Pyroligneous, 18. Pyrolignic, 18. Acide hydrocyanique, ]. Lactique, 15. Prussique, 1. Pyro-acetique, 18. Pyro- ligneux, 18. Pyrolignique, 18. Acidum aceticum empyreumaticum, 18. Borussicum, 1. Caincae, 98. Hydro- cyanicum, I. Lacteum, 15. Lactis, 15. Ligni pyro-oleosum, 18. Marinutn de- phlogisticatum, 122. Muriaticum oxy- genatum, 122. Muriaticum oxygenatum ad contagia, 122. Prussicum, 1. Pyro- aceticum, 18. Pyrolignosum, 18. Zoo- ticum, 1. Zootinicum, 1. Aconita, 23. Aconite, extract of, alcoholic, 26. Extract of, ammoniated, 26. Aconitine, 23. Acqua Binelli, 38. Acupuncturation, 27. Acupuncture, 27. jEsculine, 255. yEsculus hippocastanum, 255. iEther hydrocyanicus, 36. Prussicus, 36. Agaric blanc, 86. Agaricus albus, 86. Agothosma crenatum, 190. Aimant, 308. Air douches into the Eustachian tube, 482. Akonitin, 23. Akupunktur, 27. Alaunerde, reine, 51. Alcali vegetabile salito-dephlogisticatum, 356. Alcool de soufre, 429. Alcohol sulphuris, 429. Alexiterium chloricum, 123. Alumina, pure, 51. Alumine lactice, 51. Ammonia, arseniate of, 54. Ammoniaque, arseniate d', 54. Ammoniated counter-irritants, 466. Ammonium arsenicum, 45. Arseniksaures, 54. Amylum iodatum, 305. Antidynous counter-irritants, 466. Aqua amygdalarum, 37. Balsamica arte- rialis, 38. Binelli, 38. Chlorini, 130. Natri oxymuriatici, 411. Oxygenata muriatiea, 130. Oxygen-ornuriatica, 130. Oxymuriatica, 130. Picis, 40. Arbor vitse, American, 439. Argent, chlorure d\ 46. Cyanure d', 48. Iodure d', 50. Oxide d\ 50. Et d'am- moniaque, chlorure d', 46. Argenti chloridum, 46. Cyanidum, 48. loduretum, 50. Muriatico-ammoniati liquor, 48. Oxidum, 50. Et ammoniaci chloruretum, 46. Et ammonise chlori- dum, 46. Pra?parata, 46. Argentum chloratum, 46. Cyanogena- lum, 48. Divisum, 49. Iodatum, 50. Limatum,49. Muriaticum, 46. Muria- ticum ammoniatum, 48. Oxydatum, 50. Salitum, 46. Argil, pure, 51. Armoise commune, 57. Arnica, 53. Montana, 53. Plauensis, 53. Arnique, 53. Arsenias potassse acidus, 203, Arsenic, iodide of, 56. Arsenici iodidum, 56. Arsenikiodur, 56. Artemisia vulgaris, 57. Extractum resi- nosum, 61. Asparagi officinalis turiones, 63, Asparagus shoots, 63. Aspidium filix mas, 231. 488 INDEX OF NEW REMEDIES. Athyrium filix mas, 231. Auri chloretum, 72. Chloretum cum chlo- reto natrii, 75. Chloridum, 72. Chlo- ruretum, 72. Cyanidum, 69. Cyanu- retum, 69. lodidum, 70. Murias, 72, Nitromurias, 78. Oxydum, 79. Prae- parata, 65. Pulvis, 71. Terchloridum, 72. Teroxidum, 79. Et sodii chloru- retum, 75. Et sodii perchloruretum, 75. Aurico-natricum murias, 75. Aurum chloratum, 72. Chloratum natro- natum, 75. Limatum, 71. Metallicum, 71. Muriaticum, 72, 75. Muriaticum natronatum, 75. Nitrico-muriaticum, 78. Oxydatum, 79. Oxydulatum muri- aticum, 72. Salitum, 72. Bachelor's buttons, 327. Balaustier, 247. Ballota lanata, 80. Bark, resinous constituent of the, 392. Barosma crenata, 190. Baryi iodati hydras, 82. lodidum, 82. Baryt hydriodsaurer, 82. Baryta, hydriodate of, 82. Barytin, 445. Baryum, iodide of, 82. Beifusswurzel, 57. Gemeiner, 57. Berberina, 84. Bergerthran, 339. Berliner Blau, 212. Betoine des Savoyards, 53. Bignonia catalpa, 85. Binellisches Wasser, 38. Biogamia, 478. Biomagnetismus, 478. Bisulphuretum carbonii, 429. Bitter almonds, water of, 37. Bittermandelwasser, 37. Blausaure, 1. Blausaures Eisenoxydulzinkoxyd, 457. Blaustoffeisen, 212. BlaustorTquecksilber, 260. Blaustoffsilber, 48. Blaustoffzink, 457. Ble cornu, 400. Bleiiodid, 353. Bleu de Prusse,2l2. Blue, Prussian, 212. Bocchoe, 190. Bocho, 190. Bole, Armenian, 51. Boletus Albus,86. Laricis,86. Purgans,86. Boocho, 190. Brayera anthelmintica, 86. Brechstoff, 196. Brom, 88. Brome, 88. Bromeisen, 204. Bromidum potassii, 359. Bromine, 88. Bromkalium, 359. Bromquecksilber, 258. Brucine, 92. Buccublatter, 190. Buchu, 190. Buckeye, 255. Cceruleum Beroliniense, 212. Borussicum, 212. Cahincse radix, 95. Cainanae radix, 95. Cainca root, 95. Caincae acidum, 98. Calcar, 400. Calcaria chlorata, 98. Chlorica, 98. Chlo- retum, 98. Calcariae chlorum, 98. Calcii oxychloruretum, 98. Oxydichloru- retum, 98. Proto-chloruretum, 98. Calcis bichloruretum, 98. Chloridum, 98. Hypochloris, 98. Oxymurias, 98. Calcium, oxide de, chlorure d', 98. Pro- toxichlorure de, 98. Calendula Alpina, 53. Officinalis, 110. Sa- tiva, 110. Calenduline, 110. Caltha Alpina, 53. Sativa, 110. Calx chlorinata, 98. Oxymuriatica, 98. Caninanee radix, 95. Carbo animalis, 113. Carnis, 113. Miner- alis, 209. Carbon, sesqui-iodide of, 117. Sesqui-iodu- ret of, 117. Carboneum sulphuratum, 429. Carbonis sesqui-iodidum, 117. Sesqui-iodu- retum, 117. Carbure de soufre, 429. Carburet of sulphur, 429. Carrageen moss, 234. Castanea equina, 255. Pavina, 255. Catalpa, 85. Arborea, 85. Arborescens, 85. Cordifolia, 85. Tree, 85. Cataputia minor, 200. Catawba tree, 85. Catheterism of the Eustachian tube, 480. Cedre blanc, 439. Cetrarine, 118. Charbon animal, 113. Charcoal, animal, 113. Chaux, chlorure de, 98. Chlorate de, 98. Muriate suroxigene ou oxig^ne de, 98. Oxichlorure de, 98. Oximuriate de, 98. Souschlorate de, 98. Chestnut, horse, 255. Chimaphila, 120. Chimophila, 120. Chinicus citras, 377. Hydrochloricus, 379. Chinii acetas, 377. Ferrocyanas, 378. Hydrochloras, 379. Nitras, 380. Phos- phas, 381. Chinin, 375. Chinin, cisenblausaures, 378. Essigsaures, 377. Phosphorsaures, 381. Saltpeter- saures, 381. Salzsaures, 379. Zitron- saures, 377. Chinini citras, 377. Phosphas, 381. Chininum, 375. INDEX OF NEW "REMEDIES. 489 Chinioidine, 393. Chinium, 375. Aceticum, 375. Ferrocy- anogenatum,378. Hydrochlorieum, 379. Muriaticum, 379. Nitricum, 380. Phos- phoricum, 381. Salitum, 379. Chinoidine, 393. Cliiococcae radix, 95. Chlor, 123. Chloras kalicus depuratus, 356. Chlorate de potasse, 356. Chlore, 122. Eau de, 130. Liquide, 130. Chlorgas, 122. Chlorgold, 72. Chlorgoldnatronium, 75. Chlori aqua, 130. Liquor, 130. Chloride of soda, 411. Of zinc, 453. Chlorine, 122. Solution of, 130. Chlorini aqua, 130. Chlorinum, 122. Chlorkulk, 93. Chlornatron, 411. Chlorsilber, 46. Chlorum, 122. Chlorure d'oxide de sodium, 411. Du soude, 411. Chloruretum oxidi sodii, 411. Potassae oxidatum, 356. Chlorwasser, 130. Chondrus crispus, 234. Polymorphus, 234. Chrysanthemum, 110. Cinchonine, 137. Clavis secalinus, 400. Siliginis, 400. Cocosnussolseife, 397. Codeine, 140. Codliver oil, 339. Colchicine, 147. Colchicum, 146. Autumnale, 146. Colchique, 146. Compression, 461. Methodical, 461. Contra-irritatio, 466. Cortex adstringens Brasiliensis, 153. Counter-action, 466. Counter-irritant lotions, Granville's, 466. Ammoniated, 466. Antidynous, 466. Gondret's, 466. Granville's, 466. Counter-irritation, 466. Crayon noir, 209. Creasote, 156. Creosote, 156. Cresson de Para, 413. Crocus martis aperiens, 205. Croton oil, 333. Crusadinha raiz, 95. Cubebarum extraeti hydro-alcoholici aethe- rei syrupus, 187. Cubebine, 350. Cubebs, 182. Cyanilther, 36. Cyaneisen, 212. Cyaneisenzink, 457. C'yanidum potassii, 361. Cyankalium, 361. Cyanquecksilber, 260. Cyansilber, 48. Cyanure de zinc, 457. Cyanuretum fcrrozincicum, 457. Cyanwasserstoffsaure, 1. Cyanzink, 457. Delphinine, 187. Derosne's opiumsalz, 324. Diosma crenata, 190. Diosmine, 190. Doronic d'Allemagne, 53. Doronicum Germanicum, 53. Plantaginis folio, 35. Druck, 461. Duftstrauchblatter, 190. Eau d'amandes ameres, 37. De goudron, 40. Medicinale d'Husson, 149. Eisencyanurcyanid, 212. Eisenoxyd, eisenblausaures, 212. Eisenoxydhydrat, 225. Eisenoxydul arseniksaures, 202. Blau- saures, 212. Hydriodsaures, 215. Koh- lensaures, 205. Eisenpraparate, 202. Electricitas animalis, 475. Galvanica seu metallica, 475. Electro-magnetism, 475. Electropunctura, 193. Elixir odontalgicum, 413. Emetina, 196. Ergot, 400. Ether, hydrocyanic, 36. Acetous, injec- tions of, into the Eustachian tube, 467. Prussic, 36. Euphorbia lathyris, 200. Eupatorium huaco, 252. Exoneurism, 478. Extractum opii aceticum, 322. Extrait savonneux de l'urine, 440. Fallkraut, 53. Farrenkraut, 232. Fer, arseniate de, 202. Bromure de, 204. Carbure de, 209. Hydrate dcutocyanure de, 212. Hydriodate de, 216. Iodure de, 216. Preparations de, 202. Proto- iodure de, 212. Souscarbonato de, 205. Tritohydrocyanate ferruie de, 215. Tri- to-hydro-ferro-eyanate de, 215. Fern, male, 232. Ferri arsenias, 202. Borussias, 212. Car- bonas praecipitatus, 202. Carburetum, 209. Cyanuretum, 212. Deuto-carbonas fuscus, 205. Ferrocyanas, 212. Hydri- odas, 216. Hydrobromas, 212. lodidum, 216. loduretum, 216. Nitratis liquor, 223. Nitrici oxydati liquor, 223. Oxydi ferrocyanas, 212. Oxydum fuscum, 209. Percyanidum, 212. Persesquinilralis liquor, 216. Praeparata, 202 Sesqui- cvanidum, 216. Sesquioxydum, 202. Subcarbonas, 202. Supercarburetum. 209. Ferrum arseniatum, 202. Arscnicicum oxydulatum, 202. Borussicum, 212. 62 490 INDEX OF NEW REMEDIES. Ferrum—continued. Bromatum, 204. Carbonatum, 209. Car- bonatum praecipitatum, 205. Carboni- cum oxydulatum, 205. Carburetum, 209. Cyanogenatum, 212. Cyanuretum, 212. Hydriodatum, 216. Hydroiodi- cum oxydulatum, 216. Iodatum, 216. Nitratum, 223. Oxydatum hydratum, 225. Oxydulatum hydrocyanicum, 212. Zooticum, 212. Filix mas, 232. Fleckblume falsche, 413. Fleischkohle, 113. Fougere male, 232. Fucus crispus, 234. /j Fuligo, 237. Ligni, 237. Splendehs, 237. Fumigatio muriatico-oxygenata, *23. Fumigation de chlor, 123. De Guyton, 123. Guytonienne, 123. Hygienique, 123. Fungus of the larch, 86. Laricis, 86. Galeopsis grandiflora, 241. Ochroleuca, 241. Segetum, 241. Versicolor, 243. Villosa, 243. Galvanic brush, 478. Plates, 476. Suppo- sitory, 477. Galvanism, 475. Galvanopuncture, 194. Gebarpulver, 400. Gegenreizung, 466. Gentianine, 243. Gerbsaure, 435. Gerbestoff, 435. Gerbstoffblei, 355. Gichtthran, 339. Glanzri>ss, 237. Gold, chloride of, 72. Cyanide of, 69. Cyanuret of, 69. Iodide of, 70. Me- tallic, 71. Muriate of, 72. Natrum chlorid, 75. Natrum salzsaures, 75. Oxide of, 79. Oxydirtes, 79. Oxydul salzsaures, 72. Peroxide of, 79. Prapa- rate, 65. Pulver, 71. Saltpetersalzsaures, 78. Salzsaures, 71. Tercyanide of, 69. And soda, hydrochlorate of, 75. And soda, muriate of, 75. And sodium, chlo- ride of, 75. Gondret's counter-irritants, 466. Granatbaum, 247. Granatin, 247. Granatum, 247. Granatwurzelrinde, 247. Granville's counter-irritants, 466. Graphite, 209. Grenadier, 247. Grenadine, 247. Guaco, 252. Haloidum oxygenatum, 356. Hanfnessel, grossblumigte, 241. Harnstoff, 440. Herba sideritidis, 241. Herbe a. pisser, 120. Herbstblume, 146. Herbslzeitlose, 146. Hippocastanum, 255. Hohlzahns, grossbliithigen, 241. Holzessig, 18. Holzsuure, 18. Brenzliche oder brandige, 18. Hornseed,400. Horse chestnut, 255. Huaco, 252. Huile de foie de poisson, 339. De Morue, 339. De pignon dTnde, 333. Volatile de moutarde, 345. Hydrargyri bicyanidum, 260. Borussias, 260. Bromidum, 260. Deutobromidum, 260. Cyanuretum, 260. Deutoiodure- tum,268. Iodidulatum, 265. lodidum, 265. Perbromidum, 260. Prajparata, 258. Protobromidum, 260. Proto-iodi- dum, 265. Proto-ioduretum, 265. Prus- sias, 260. Hydrargyrum biniodidum, 268. Broma- tum, 260. Cyanogenatum, 260. Hydro- cyanicum, 260. Iodatum, 265. Ioda- tum flavum, 265. Iodatum rubrum, 268. Perbromatum, 260. Periodatum, 268. Hydras ferricus, 225. Hydriodate of potassa, 365. Hydriodic acid, liquid, 301. Hydrocyanate of potassa, 361. Hydrocyanicus aether, 36. Hydrocyansaure, 1. Hydroiodas kalicus, 365. Indicum, 273. Indicus color, 273. Indigo, 273. Infusum picis liquidae, 40. Picis empy- reumaticae liquidae, 40. Injections ot air, &c. into the Eustachian tube, 479. lod, 278. lode, 278. Iodarsen, 56. Iodarsenik, 56. Iodbaryum, 82. Iodeisen, 216. Iodide of quinine, 305. Of starch, 305. Of sulphur, 305. Of zinc, 433. lodidum amyli, 305. Hydrargyricum, 268, Hydrargyrosum, 265. Plumbi, 354, Potassii, 365. Quinina;, 305. Iodine, 278. Iodkalium, 365. Iodquecksilber, gelbes,265. Im maximum, 268. Im minimum des Iods, 265. Rothes, 268. Iodschewefel, 305, 433. Iodsilber, 50. Iodstarke, 305. Iodstarkmehl, 305. Iodum, 278. Iodure d'amidon, 305. De soufre, 305,433. Ioduret of sulphur, 305, 403. loduretum amyli, 305. INDEX OF NEW REMEDIES. 491 lodzink, 460. Iron, arseniate of, 202. Bromated, or bro- mide of, 204. Carburet of, 209. Cya- nuret of, 212. Hydriodate of, 216. Hy- drobromate of, 204. Hydro-oxide of, 225. Iodide of, 216. Ioduret of, 216. Ni- trate of, solution of, 223. Oxide of, hy- drated, 225. Peroxide of, 205. Peroxide of, hydrated, 225. Persesquinitrate of, solution of, 223. Protoiodide of, 216. Protoioduret of, 216. Protoxide of, hy- driodate of, 225. Prussiate of, 212. Ses- quioxide of, 225. Subcarbonate of, 225. Tritoxide of, hydrated, 225. Irritamentum metallorum seu metallicum, 475. Johanniswurzel, 231. Kahincae radix, 95. Kali chloricum, 356. Chlorsaurcs, 356. Hydrobromicum, 359. Hydroiodinicum, 365. IodwasserstofFsaures, 365. Biom- wasserstoffsaures, 359. Hydroiodicum, 365. Kalium bromatum, 359. Bromid, 359. iodatum, 365. Kalkchlorid, 98. Kaminruss, 237. Kinine, 375. Kininum, 375. Kodein, 140. Kohle, thierische, 113. Kohlenschwefel, fliissiger, 429. Kohlenstoffeisen, 209., Kohlensulfurid, 429. Krahenaugen, 327. Geistiges Extraktder, 327. Kreasote, 156. Kreosote, 156. Krotonol, 333. Kubebenpfeffer, 182. Kubebin, 182. Labarraque's disinfecting liquid, 411. Lactucarium, 306. Lathyris, 200. Lattichopium, 306. Lead, black, 209. Iodide of, 353. Tan. nate of, 355. Lebensbaume, gemeine, 439. Leberthran, 339. Leonurus lanata, 80. Leopard's bane, 53. Lerschenschwamm, 86. Lettuce opium, 306. Lichen carrageen, 234. Lime, chloride of, 98. Liqueur desinfectante de Labarraque, 108. . __n Liquor acidi muriatici oxygenati, 1JU. Alexiterius oxygenatus, 130. Disinfect- ing of Labarraque, 108. Morphinaecitra- tisT 323. Opii, 321. Opii sedativus, 322. Sodse chloridi, 411. Sodas chlori- natae, 411. Magnes, 308. Magnet, 308. Magnetism, animal, 478. Malogranatum, 247. Mannastoff, 310. Mannazucker, 310. Mannite, 310. Marigold, garden, 110. Single, 110. Marronier, 255. D'Inde, 255. Matiere de Derosne, 324. Matter of Derosno, 324. Mercure, cyanure de, 260. Deuto-iodide de, 268. Hydrocyanate de, 260. Periodure de, 268. Preparations de, 258. Proto- iodure de, 265. Prussiate de, 260. Mercury, bicyanide of, 260. Biniodide of, 268. Bromide of, 260. Cyanide of, 260. Deutoiodide of, 268. Hydrocya- nate of, 260. Preparations of, 258. Proto-iodide of, 265. Proto-ioduret of, 265. Prussiate of, 260. Mesmerism, 478. Milchsaure, 15. Moleplant, 200. Morphei acetas, 318. Morpheum, 313. Morphin essigsaures, 318. Schwefcl- saures, 322. Morphines bimeconas, 324. Sulphas, 322. Tartras, 323. Morphine, 313. Acetate of, 318. Bime- conate of, 324. Citrate of, 323. Muri- ate of, 323. Sulfate de, 322. Morphinum, 313. Morphium, 313. Mort aux chiens, 146. Moss, carrageen, 234. Corigeen, 234. Irish, 234. Mousse d'Irlande, 234. Perlee, 234. Moxa, 472. Moxiburium, 472. Mugwort, 57. Muride, 88. Murigene, 122. Mustardseed oil, 345. Mutterkorn, 400. Nadelstich, 23. Narcotine, 325. Narda celtica altera, 53. Narkotin, 325. Natrum chloratum, 411. Chloricum* 411. Oxyrnuriaticum, 411. Nephrine, 440. Neurogamia, 478. Noix vomique, 327. Extrait alcoolique de, 327. Nux vomica, 327. Extract alcoholic of, 327. Ofenruss, 237. Oil, codliver, 339. Croton, 338. Of mus- tard seed, 345. Oleum sethereum florum arnicte, 53 .Ethereum seminum sinapis, 345. Cro- 492 INDEX OF NEW REMEDIES. Oleum—continued. tonis, 338, Jecinoris aselli, 339. Morr- huae, 339. Sinapis, 345. Tiglii, 333. Volatile seminum sinapis, 345. Opiane, 324. Opium, lettuce, 306. Or, chlorure d\ 72. Cyanure d', 71. Divis-e, 71. Metallique, 71. Muriate d', 72. Preparations d', 65. Proto-iodure d', 72. Et soude hydrochlorate d', 75. Etsoude, muriate d', 75. Oxydirt-salzsaures Natronwasser, 411. Panacea lapsorum, 53. Papaverine, 313. Paraguay roux, 413. Paratinktur, 413. Pariser blau, 212. Pfefferstoff, 350. Phloridzine, 348. Pierre d'aimant, 308. Pigmentum indicum, 273. Piper caudatum, 182. Cubeba, 182. Piperine, 350. Pipsissewa, 120. Platinum, 353. Plomb, iodure de, 353. Tannate de, 355. Plombagine, 209. Plumbago, 209. Plumbi iodidum, 353. loduretum, 353. Tannas, 355. Pneumokatharterion, 107. Poison nut, 327. Poivre a queue, 182. Polypodium filix mas, 232. Polyporus officinalis, 86. Pomegranate, 247. Potassa, chlorate of, 356. Hydrocyanate of, 361. Hydriodate of, 365. Hydriodate of, ioduretted, 366. Hydrobromate of, 359. Potassae chloras, 356. Euchloras, 356. Hydrobromas, 359. Murias hyperoxy- genatum, 356. Murias oxygenatum, 356. Potasse bromure de, 359. Hydriodate de, 365. Iodure de, 365. Potassii bromidum, 359. Cyanidum, 361. Cyanuretum, 361. Iodidum, 365. Iodo- hydrargyras, 373. loduretum, 365. Oxygeno-chloruretum, 356. Proto-hy- driodas, 365. Protoxidi hydriodas, 365. Potassium, bromide of, 359. Cyanide of, 361. Cyanuret of, 361. Iodide of, 365. Iodo-hydrargyrate of, 373. Ioduret of iodohydrargyrate of, 373. Ioduret of, 365. Protoxide of, chlorate of, 356. Potio picea, 40. Pondre de blanchement, 98. De Tennant, iS8. Powder, bleaching, Tennant's, 98. Principium adstringens, 435. Scytodephi- cum, 435. Prussiate de potasse et de fer, 212. Ptarmica monlana, 53. Pulvis ad fumigationes muriaticus, 122. Punica granatum, 247. Pyrola umbellata, 120. Pyrole en ombelle, 120. Quecksilber blausaures, 260. Bromid, 258. Bromilr, 258. Deutoiodiir des, 268. Iodid, 268. Iodid gelbes, 265. Iodi- dul, 265. Praparate, 258. Protoio- diir des, 265. Quina, 375. Quinia, 375. Quiniae sulphas impurus, 393. Quinina, 375. Quinine, 375. Acetate of, 377. Citrate of, 377. Extract of, 393. Ferrocyanuro de, 378. Nitrate of, 380. Quinine, phosphate of, 381. And cincho- nine, tannate of, 392. Quininum, 375. Quinium, 375. Raiz crusadinha, 95. Prcta, 95. Reissblei, 209. Resina chinae praeparata, 393. Ringelblume, 110. Rosscastanien, 255. Russ, 237. Rye, corned, 400. Spurred, 400. Sabadillin, 442,445. Saccharum mannce, 310. Safran ba-tard, 146. De mars aperitif, 205. Des pres, 146. Saffron meadow, 146. Sal essentiale corticis Pcruviani, 375. Salicine, 394. Salt of Derosne, 321. Sapo cacaotinus, 397. Coconeus, 397. Kalicus, 397. Mollis, 397. Niger, 397. Viridis, 397. Satzmehliodur, 305. Savon de cacoa, 397. Mou, 398. Noir,398. Schmierseife, 398. Griine, 398. Schwanzpfeffer, 182. Schwefelalcohol, 429. Schwefelkohlenstoff, 429. Schwererde, iodwasserstoffsaurc, 82. Secale cornutum, 400. Luxurians, 400. Secalis mater, 400. Seetang, 234. Seigle ergotee, 400. Sel de Derosne, 324. Essentiel d'opium, 324. Senfol, a:therischcs, 345. Serpentariae Braziliensis radix, 95. Silberammonium salzsaures, 47. Silberoxyd, 50. Silber, oxydirtes, 50. Praparate, 43. Sal- miak, 47. Salzsaures, 46. Zertheil- tes, 49. Silver, chloride of, 46. Cyanide of, 48. Iodide of, 50. Ioduret of, 50. Metal- lie, 49. Muriate of, 46. And ammo- | nia, chloride of, 17. And ammonia, chloruret of, 47. INDEX OF NEW REMEDIES. 493 Sinapis oleum, 345. Soap of the cocoanut oil, 397. Soft, 397. Soda chlorinata, 411. Chloruret of, 411. Chlorite of, 411. Hypochlorite of, 411. Sodae chloridum, 411. Chloruretum, 411. Oxymurias, 411. Sodium, auro-terchloride of, 75. Solutio alexiteria oxygenata, 130. Soot, 237. Souci, 110. Ordinaire, 110. Soufre carbure, 429. Iodure, 433. Species pro vaporibus superoxydi muriati- ci, 123. Sphaerococcus crispus, 234. Spiegelruss, 237. Spilanthus oleraceus, 413. Spear-leaved, 413. Spiritus salis marini dephlogisticatus, 122. Sponsa solis, 110. Spur, the, 400. Spurge, caper, 200. Garden, 200. Starch, iodide of, 305. Starkmehliodiir, 305. Stockfisch leberthran, 339. Strychnin essigsaures, 425. Iodsaures, 426. Salpetersaures, 427. Schwefelsaures, 428. Strychnine, 414. Acetate of, 425. Hy- driodate of, 426. Iodate of, 426. Ni- trate of, 427. Sulphate of, 428. Strychninum, 414. Strychnium, 414. Suffitus chlorini, 122. Oxymuriaticua, 122. Suie, 237. Sulfure de carbon,42 9. Sulphuret of carbon, 429. Sulphuretum carbonii, 429. Sulphuris carburetum, 429. Iodidum, 305, 433. loduretum, 433. Tabac de Montagne, 54. Des Savoyards, 54 Des Vosges, 54. Tang krauser, 234. Tannas plumbi, 355. Tannicum purum, 435. Tannin, 435. Tar water, 40. Tellurismus, 478. Terra aluminis, 51. Aluminosa. pura, 51. Argillacea pura, 51. Bolaris, 51. Si- gillata, 51. Theerwesser, 40, Thierkohle, 113. Thonerde, reine, 51. Thridace, 306. Thuya, 439. Du Canada, 439. Occiden- tal, 439. Tithymalus latifolius, 200 Tue-chien, 146. Ulva crispa, 234. Urea, 440. Uree, 440. Uricum, 440. Ustilago, 400. Vauqueline, 414. Veratrine, 442. Sulphate of, 452. Verrucaria, 110. Vieillotte, 146. Vinaigre de bois, 18. Vomic nut, 327. Wasserstoffblausaure, 1. Wiesensafran, 146. Winter green, 120. Wintergrun, holdenbliihtigen, 120. Wohlverlei, 53. Wohlverleiol, 54. Wolfstrapp wolliger, 80. Woodsoot, 237. Zeitlose, 146. Zinc, butter of, 453. Chloride of, 453. Cyanuret of, 456. Ferrocyanate of, 457. Ferrohydrocyanate of, 457. Hydro- chlorate of, 453. Hydrocyanate of, 456. Iodide of, 460. Muriate of, 453. Prus- siate of, 456. Zinci butyrum, 453. Chloridum, 453. Chloruretum, 453. Cyanidum, 457. Cyanuretum, 457. Ferrohydrocyanas, 457. Iodidum, 460. loduretum, 460. Zincum Borussicum, 456. Chloratum, 453. Cyanogenatum, 456. Ferrohy- drocyanicum, 457. Hydrocyanicum, 456. Iodatum, 460. Muriaticum (oxy- datum) 453. Zooticum, 456. Zinkbutter, 453. Zinkchlorid, 453. Zinkcyanur, 457. Zinkeisenblausaurer, 457. Zinkeisencyaniir, 457. Zinkoxyd, eisenoxydul, 457. Zinkoxyd salzsaures, 453. Zinkoxydul blausaures, 456. Zoomagnetismus, 478. iV INDEX OF DISEASES AND THEIR REMEDIES. Abdomen, inflammation of the (hydrarg. cyanur.) 262. Abscesses, suppurating (creosoton) 166. Acidity of the stomach (argilla) 52. Acne (sulphur, iodid.) 434. Indurata (sulphur, iodid.) 434. Rosacea (acid. hydrocyan.) 11. Rosacea (creosoton) 173. Adiposis (ballota lanata) 81. (Iodinum) 300. After pains (sulphuris carburetum) 431. Amaurosis (acupunct.) 33. (Ammoniated counter-irritants) 466. (Galvanismus) 475. (Nux vomica) 330. (Strychnina) 422. Incomplete (electro-punct.) 194. Amblyopia (strychnina) 422. AmenorrhcEa (artemisia) 62. (Brominum) 92. (Caincae radix) 96. (Calendula) 111. (Ferr. iodid.) 220. (Iodinum) 296. (Po- tassii bromid.) 360. (Sccale cornutum) 407. (Sulphuris carburetum) 431. Anasarca (acid, hydrocyan.) 10. (Acu- punct.) 333. Aneurism (acupunct.) 33. Angiectasis (zinci chlorid.) 456. Angina pectoris (galvanism) 477. (Mag- net) 309. Anthrax, malignant (chlorin. aq.) 133. Aphonia (chlorin.) 126. (Cubebae) 184. (Ol. croton) 335. (Strychnina) 422. Aphthae, asthenic (chlorin. aq.) 135. Aphthous sores (liq. ferr. persesquinit.) 225. Ulceration (creosoton) 182. Arthritis, chronic (brominum) 92. (Com- pressio) 461. Arthrocace (ol. jecinor. aselli) 342. Ascites (acupunct.) 33. (Cainca? radix) 96. (Euphorb. ol.) 201. (Iodinum) 294. Asphyxia (acupunct.) 24. (Galvano punc Asphyxia—continued. tur.) 194. (Sulphuris carburetum) 431. Asthenia, chronic (potassa? chloras) 357, 358. Asthma (bignonia catalpa) 85. (Creoso- ton) 178. (Galvanism) 477. (Ol. cro- ton) 335. Humoral (sulphur, iodid.) 434. Nervous (magnet) 309. Pulveru- lentum (acid, hydrocy.) 10. Spasmodic (acid, hydrocyan.) 10. (Iodinum.) 296. Atrophy (brucina) 94. (Ol. jecinor. aselli) 341. Partial (nux vomica) 329. Biles (ammoniated counter-irritants) 471. Bladder, atony of the (diosma) 192. Ca- tarrh of the (cort. adstring. brazil.) 155. Diseases of the (diosma) 192. Inflammation of the (luligo) 239. Bleeding from leech bites (creosoton) 165. Blennorrhoea (acid, hydrocyan.) 12. (Chi- maphila") 121. (Cort. adstring. brazil.) 154,155. (Ferr. iodid.) 21. (Piperina) 353. (Tannicum purum) 438. Of the bladder, (diosma) J 92. Of the eye (cal- cis chlorid.) 104. (See gonorrhoea.) Boils, see biles. Bones, pains in the (zinci ferrohydrocy- anas) 458. Tumors of the (auri prae- par.) 69. Bowels, painful affections of the (acid. hydrocyan.) 11. Brain, chronic affections of the (ammo- niated counter-irritants) 466. Bronchi, dilatation of the (chlorin.) 126. Inflammation of the (ammoniated coun- ter-irritants) 470. Bronchitis (acid, hydrocyan.) 9. (Iodi- num) 292. (Mannitum) 312. (Strych- nina) 423. Chronic (aq. picea) 43. 496 INDEX OF DISEASES AND THEIR REMEDIES. Bronchitis—continued. Chronic (chlorin.) 126, 127. Chronic (colchicum) 150. Chronic (creosoton) 176. Chronic (galeopsis) 241. Chronic (salicina) 396. Bronchocele (ferr. iodid.) 220. (See goitre.) Bronchorrhcea (creosoton) 175. Bubo, ulcerated (creosoton) 170. Burns (calcis chlorid.) 101,108. (Creoso- ton) 166. (Sodae chlorid.) 447. (Sul- phuris carburetum) 431. Severe (com- pressio) 401. Cachexia (acid, pyrolign.) 20. (Chlorin.) 128. Mercurial (auri praepar.) 67. (See Dyscrasy. Calculous pains (diosma) 192. Calculus (chimaphila) 120. Phospbatic (acid, lact.) 17. Canoer (acid, pyrolign.) 20. (Aur. nitrico- muriat.) 79. (Auri. praepar.) 69. (Cal- cis chlorid.) 219. (Calendula) 110. (Ferr. arseniat.) 203. (Ferr. carb. praec.) 206. (Ferr. iodid.) 220. Of the heart (calen- dula) 111. Of the breast (creosoton) 169. Of the breast (fuligo) 237. Of the face (creosoton) 169. Of the integuments (calendula) 111. Of the lip (creosoton) 169. Open (carbo animalis) 115, 116. Of the skin (creosoton) 169. Of the tongue (iodin.) 297. Of the uterus (auri prae- parat.) 69. Of the uterus (calendula) 110, 111. Of the uterus (creosoton) 168. Of the uterus (morphinae acetas.) 321. Cancerous ulcers (chlorin. aq.) 135. (Po- tass, iodid. 371. Of the face (creosoton) 169. Cancrum oris (acid, pyrolign.) 20. (Calcis chlorid.) 100. (Chlorin. aq.) 134, 135. (Creosoton) 168. Carbuncle, sloughing (creosoton) 168. Carbunculus malignus (aq. chlorin.) 133, 135. Cardialgia (artemisia) 62. (Calendula) 111. (Nux vomica) 329. (Zinci fcrro- hydrocyanas) 458. Carditis (ammoniated counter-irritants) 470. Caries of bones (acid, pyrolign.) 20. Of the fibula, &c. (creosoton) 169. Scro- fulosa (ol. jecinor. aselli) 342. Scrofu- lous (creosoton) 168,181. Of the teeth (calcis chlorid.) 103. Catalepsy (strychnina) 423. Catamenia, obstruction of the. (See Ame- norrhcea.) Cataract, disintegrated (carbo animalis) 105. Incipient (ammoniated counter-irri- tants) 466. Catarrh, chronic (acid, hydrocyan.) 9. (Aq. picea) 41. (Chimaphila) 121. (Chlo- rin.) 126, 128. Catarrh, pulmonary (galeopsis) 241. (Man- nitum) 312. | Catarrhus urethrae (cubeba?) 184. Vesicae (aq. picea) 43. Vesica? (caincoe radix) 97. Vesica? (cubeba?) 185. Vesica? (diosma) 192. Cephalalgia (acupunct.) 33. Chronic (ar- temisia) 62. Intermittent (quinina? sul- phas) 387, 391. Nervous (acid, hydro- cyan.) 11. Periodical (zinci ferrohydro- cyanas) 458. Syphilitic (hydrarg. cy- anur.) 263. (See headach.) Chancre (creosoton) 170, 182. (Hydrarg. cyanur.) 263. Chaps (ol. jecin. aselli) 343. Chest, diseases of the (chlorin.) 125. Af- fections of the (fuligo) 239. Chilblains (calcis chlorid.) 102, 109. (Cre- osoton) 167. Chlorosis (artemisia) 62. (Ferr. iodid.; 220. Cholera (creosote) 178. (Diosma) 192. (Guaco) 254. Morphine? acetas.) 321. (Nux vomica) 332. (Strychnina) 423. Morbus (artemisia) 62. Chorea (acid, hydrocyan.) 10. (Ferr. carb. praec.) 208. (Iodinum) 295. (Ol. jecinor. aselli) 343. (Strychnina) 423. (Veratri- na) 448. (Zinci ferrohydrocyanas) 458. Colic, hysterical (ol. sinapis) 348. Colica pictonum (nux vomica) 329. Condylomata (creosoton) 171. (Hydrarg. deuto-iodur.) 270. (Thuya occidenta- lis) 439. Congestions in the head (ammoniated counter-irritants) 470. Constipation (galvanism) 478. (Veratri- na) 450. Contagion (calcis chlorid.) 89. (Chlorin.) 129. Contusions (acupunct.) 33. (Creosoton) 167. Convulsions (ammoniated counter-irritants) 470. (Auri praepar.) 65. (Magnet) 309. (Compression of arteries') 465. (Potass. cyanid.) 364. During dentition (chlo- rin. aq.) 132. Hysterical (indigum) 273. Convulsive affections (acupunct.) 33. Dis- eases of childhood (artemisia) 61. Cornea, granulations on the (fuligo) 238. Obscurity of the (calcis chlorid.) 104. Opacity of the (hydrarg. deuto-iodur.) 270. Opacity of the (ol. jecinor. aselli) 342. Spots on the (fuligo) 238. Coryza (cubeba?) 184, 185. Cough (lactucarium) 307. Nervous (tan- nicum purum) 437. Spasmodic (lactu- carium) 308. Spasmodic, dry (fucus crispus) 235. Violent (asparag. turion.) 64. Coxalgia (iodinum) 299. Coxarthrocace (ol. jecinor. aselli) 343. Cramp (ammoniated counter-irritants) 470. (Magnet) 309. Of the stomach (nux vomica) 332. Of the stomach (zinci ferrohydrocyanas) 458. INDEX OF DISEASES AND THEIR REMEDIES. 497 Croup, hysteric (creosoton) 178. Crusta lactea (asparag. turion.) 64. (Cre- osoton) 172. Cutaneous diseases (arsenias ammoniae) 55. (Acid, hydrocyan.) 12. (Asparag. turion.) 64. (Auri cyanidum) 70. (Cal- cis chlorid.) 103. (Chlorin.) 128. (Chlo- rin. aq.) 134. (Creosoton) 172. (Ferr. carbur.) 210. (Fuligo) 238. (Hydrarg. deuto-iodur.) 270. (Iodid. sulph.) 306. (Iodinum) 296. (Ol. jecinor. aselli) 343. (Potassa? chloras) 357. (Soda? chlorid.) 412. (Sulphur, iodid.) 434. Syphilitic (hydrarg. proto-iodur.) 267. Cynanche (cort. adstring. Brazil.) 154. Tonsillaris. (Sec Sore throat.) Deafness (acid, pyrolign.) 20. (Creosoton) 174. (Galvanism) 475. Erethitic ner- vous (injections of vapour of acetous ether) 483. Nervous (injections of va- pour of acetous ether) 483. Nervous, torpid (injections of vapour of ether) 483. Debility (ferr. iodid.) 220. (Nux vomica) 329. (Piperina) 352. General (quinina? et cinchoninae tannas) 392. Nervous (Quinina? sulphas) 388, 390. Paralytic (ammoniated counter-irritants) 471. Decubitus gangraenosus (plumb, tannas) 356. Delirium tremens, (magnetism, animal) 479. Dentition (chlorin.) 132. Diabetes mellitus (creosoton) 178. (Tan- nicum purum) 436. (Urea) 441. Diarrhoea (acid, pyrolign.) 20. (Argilla) 52, 53. (Artemisia) 62. (Carbo ani- malis) 115. (Fucus crispus) 235. (Indi- gum) 273. (Liq. ferr. persesquinit.) 224. (Strychnina) 423. (Veratrina) 450. Choleric (nux vomica) 330. Chronic (ferr. cyanuret.) 213. Chronic (mor- phinae acetas) 321. Chronic (nux vomi ca) 330, 332. Diathesis phthisica (chlorin. aq.) 134. Diphtheritis (fuligo) 238. Diplopia (acupunct.) 33. Discharges from the nose (iodinum) 298. Offensive (acid, pyrolign.) 20, 21. Disinfection (chlorin.) 129. (Chlorin. aq.) 135. Dropsy (acid, hydrocyan.) 10. (Acid, pyro- lign.) 20. (Asparag. turion.) 64. (Au- rum muriat.) 73. (Aur. muriat. natron.) 74. (Auri praeparat.) 69. (Ballota la- nata) 80, 81. (Caincae radix) 96. (Chi- maphila) 120, 122. (Chlorin. aq.) 134. (Colchicum) 150. (Ferr. iodid.) 221. (Hippocastanum) 256. (Iodinum) 294. (Ol. sinapis) 348. (Urea) 442. (Vera- trina) 443, 452. Of the ovary (iodin.) 297. After scarlatina (colchicum) 150. Dumbness (galvanism) 475. Dyscrasy (ferr. iodid.) 221. (Sulphuris carburetum) 431. After intermittents (ferr. cyanur.) 213. (See Cachexia.) Dysentery (argilla) 52. (Artemisia) 62. (Calcis chloridum) 99. (Ferr. cyanur.) 213. (Fucus crispus) 235. (Nux vo- mica) 331, 332. (Secale comutum) 407. (Strychnina) 423. Putrid (chlorin. aq.) 133. Dyspepsia (acid, lact.) 17. (Argil.) 52. (Berberina) 85. (Carbo animalis) 115. (Chimaphila) 121. (Diosma) 192. (Ferr. iodid. 220. (Hippocastanum) 256. (Nux vomica) 331. (Ol. sinapis) 348. (Pipe- rina) 352. (Quinina? sulphas) 390. (Strychnina) 423. Dysphagia (artemisia) 62. Spasmodic (acid, hydrocyan.) 9. Dyspnoea (galvanism) 476. (Potass, cya- nid.) 364. Dysuria (chimaphila) 120. Eclampsia infantum (artemisia) 61, 63. Eczema (ol. jecinor. aselli) 343. Engorgements, visceral (ferr. iodid.) 221. Euteralgia (acid, hydrocyan.) 11. Enteritis (acid, hydrocyan.) 9. Epilepsy (acid, hydrocyan.) 11. (Acu- punct.) 33. (Ammoniated counter-irri- tants) 470. (Artemisia) 59. (Compres- sion of arteries) 465. (Creosoton) 178. (Ferr. cyanur.) 213, 214. (Galvanism) 478. (Granatum) 251. (Indigum) 273. (Iodinum) 295. (Magnet) 309. (Nux vomica) 330. (Strychnina) 423. (Zinci chlorid.) 455. (Zinci ferrohydrocyanas) 458. Epistaxis (cort. adstring. Brazil.) 154. (Cre- osoton) 165. (Secale comutum) 407. Erethism, gangrenous, 402. Morbid (po- tassa? chloras) 357. Ergotism, 401. Erysipelas (chlorin. aq.) 134. (Colchicum) 150. (Compressio) 461. Of the face. (Cort. adstring. Brazil.) 154. Eustachian tube, obstructed. (Injections of air) 479. Exanthemata, febrile (chlorin. aq.) 133. Exanthematous diseases (cort. adstring. Brazil.) 154. Excoriation from lying (creosoton) 167. Of the skin (ol. jecinor. aselli) 343. Syphilitic (aurum melallicum) 71. Excrescences, syphilitic (aurum metalli- cum) 71. Eye, black (calcis chlorid.) 102. Fainting, hysteric (sulphuris carburetum) 431. Febrile affections (colchicum) 149. Dis- eases (morphina) 317. Fever, brain (compression of arteries) 465. Gastric (artemisia) 62. Gastric (chlorin. 63 498 INDEX OF DISEASES AND THEIR REMEDIES. Fever—continued. aq.) 134. Hectic (chlorin. aq.) 134. Intermittent (cetrarine) 119. Intermit- tent (chlorin. aq.) 133. Irritative (chlo- rin. aq.) 132. Nervous (chlorin. aq.) 132. Paroxysmal (quinina? sulphas) 383, 388, 389, 391. Petechial (aq. chlo- rin.) 133. Putrid (acid, pyrolign.) 20. Putrid (chlorin. aq.) 133. Summer (qui- nina? sulphas) 388. Typhous (soda? chloridum) 412. Fissures of the skin (creosoton) 167. (01. jecinor. aselli) 343. Fistula? (acid, hydrocyan.) 11. (Calcis chlorid.) 101. (Ol. jecinor. aselli) 345. (Potass, iodid.) 372. Flatulence (creosoton) 175. Fluor albus. (See Leucorrhcea.) Fo?tor oris (calcis chloridum) 99, 106,107. (Chlorin. aq.) 135. Frost bites (calcis chlorid.) 102, 108. Fungous tumour (creosoton) 170. Fungus of the neck of the uterus (aur. nitrico-muriat.) 78. Ganglion (acupunct.) 35. (Hydrarg. deuto- iodur.) 271. Ganglionic system, disorder of the (ferr. cyanur.) 215. Gangrene (acid, pyrolign.) 20. (Calcis chlorid. 102. Hospital (calcis chlorid.) 101, 108. Hospital (creosoton) 168. Of the lungs (chlorin.) 135. Of the scro- tum (calcis chlorid.) 101. Gastralgia with acid (cinchonin.) 139. Gastricisrn (carbo animalis) 115. (Manni- tum) 312. Gastritis (codeine) 145. Gastrodynia (acid, hydrocyan.) 10. (Acu punct.) 33. (Creosoton) 178. (Nux vomica) 330. (Ol. sinapis) 348. Gastromalacia (acid, pyrolign.) 20. Chlo- rin. aq.) 134. Genital organs, atony of the (cubeba?) 184. Debility of the (cort. adstring. Brazil.) 154. Debility of (nux vomica) 329. Glanders, chronic (creosoton) 179. Glands, enlarged (carbon sesqui-iodid.) 117. Enlarged (plumbi iodid.) 355. In- duration of the (hydrarg. deuto-iodur.) 270. Mammary, enlarged (veratrina) 450. Meibomian, copious secretion from the (calcis chlorid.) 104. Mesenteric, en- larged (iodinum) 289. Of the neck, in- flamed (hydrarg. deuto-iodur.) 270. Scrofulous swellings of the (calcis. chlo- rid.) 103. Strumous swellings of the (chlorin. aq.) 135. Submaxillary, en- larged (iodinum) 290. Tumefied, stru- mous (hydr. proto-iodur.) 290. Glandular affections (aurum muriat.) 74. (Iodinum) 289. (Veratrina) 450. Gleet (creosoton) 171. (Secale comutum) 411. Old (tannicum purum) 438. Goitre (brominum) 91. (Calcis chlorid.) 103, 109. (Hydrarg. deuto-iodur.) 270. (Iodinum) 288, 305. (Potassii bromid.) 360. (Potass, iodid.) 370. Scirrhous (carbo animalis) 115, 117. (Sulphuris carburetum) 431. (Veratrina) 450. Gonorrhoea (auri praepar.) 68. (Calcis. chlorid,) 100. (Calcis chlorid.) 105, 106. (Chlorin. aq.) 135. (Creosoton) 171. (Cubeba?) 183. (Diosma) 192. (Secale comutum) 407. (See Blennorrhea.) Gout (acupunct.) 33. (Ammoniated coun- ter-irritants) 471. (Ballota lanata) 81. (Colchicum) 148, 149. (Compression of arteries) 464. (Creosoton) 177, 180. (Iodinum) 299. (Magnet) 309. (Moxa) 472. (Ol. croton.) 335. (Ol. jecinor. aselli) 341. (Sulphuris carburetum) 431, 433. (Veratrine) 332. Atonic (hippocastanum) 256. Chronic (chi- maphila) 120, 122. Chronic (diosma) 192. Suppressed (ammoniated counter- irritants) 471. Gouty swellings of bones (potass, iodid.) 372. Gravel, white (acid, lact.) 17. Growths, morbid (baryum iodatum) 83. Gums, scorbutic ulceration of the (creoso- ton) 169, 180. Gutta rosacea (fuligo) 238. (Sulph. iodid.) 434. Haematuria (diosma) 192. (Secale comu- tum) 407. Haemoptysis (cort. adstring. Brazil.) 154. (Creosoton) 166, 180. (Galeopsis) 242. (Lactucarium) 308. (Secale comutum) 407. Head, determinations to the (chlorin. aq.) 132. Headach, intermittent (quinina? sulphas) 386, 391. Nervous (strychnina) 423. Nervous (ammoniated counter-irritants) 470. (See Cephalalgia.) Hearing, defective from otorrhcea (cubeba?) 184. Heart, active diseases of the (aconitin.) 25. Diseases of the (asparag. turion.) 64. Enlargement of the (acid, hydrocyanic) 10. Hypertrophy of the (asparag. tu- rion.) 64. Hypertrophy of the (bro- minum) 92. Hypertrophied (iodin.) 297. Hypertrophy of the (potass, bro- mid.) 360. Hypertrophy of the (potass. iodid.) 370. Palpitation of the (asparag. turiones) 64. Spasmodic affections of the (acid, hydrocyan.) 9. Hectic fever (chlorin. aq.) 134. Hemicrania (acid, hydrocyan.) 10. Hemiplegia (nux vomica) 330. (Strych- nina) 421. Hemorrhage (aq. binelli) 38. (Cort. ad- string. Brazil.) 154. (Creosoton) 163. (Ferr. iodid.) 221. (Secale comutum) 407. (Tannicum purum) 437. Active INDEX OF DISEASES AND THEIR REMEDIES. 499 Hemorrhage—continued. (acid, hydrocyan.) 9. Capillary (creo- soton) 166. From the gums (creosoton) 166. From leech bites (creosoton) 165. From the lungs. (See Hamoptysis.) Uterine (creosoton) 166. Uterine (ferr. iodid.) 221. Uterine (Secale comutum) 407. Uterine (tannicum purum) 436. Hepatic diseases. (See Liver affections.) Hernia humoralis. (See Orchitis.) Incar- cerated (sulphuris carburetum) 431. Herpes (acid, hydrocyan.) 11. (Calcis chlorid.) 103. (Chlorin. aq.) 135, 136, (Creosoton) 172, 182. (Ferr. carbur.) 208. (Fuligo) 238. (Hydrarg. cyanur.) 263. (Hydrarg. deuto-iodur.) 270. (01. jecinor. aselli) 343. (Potass, bromid.) 360. (Potass, iodid.) 368. (Sapo coco- neus) 398. Exedens (creosoton) 172. Phagedenic tuberculous (arsenic, iodat.) 57. Herpetic ulcers (creosoton) 169. Hiccough, spasmodic (magnet) 309. Hoarseness (fucus crispus) 235. (Ol. cro- ton) 335. Hooping cough (acid, hydrocyan.) 9, 14. (Ferr. carb. praec.) 207. (Ol. croton) 335. Hordeolum (hydrarg. deuto-iodur.) 270. Hydrocele (acupunct.) 34. (Chlorin.) 119. (Iodinum) 294. (Iodinum) 300. Hydrocephalus (iodinum) 294. Hydrocyanic acid, poisoning by (chlorin.) 127. (Chlorin. aq.) 134. Hydrophobia (chlorin. aq.) 134. (Compres- sion of the arteries) 465. Hydrothorax (acid, hydrocyan.) 10. (Col- chicum) 150. (Iodinum) 294. Hygroma (iodinum) 294. Hyperaemia (ammoniated counter-irritants) 471. (See Inflammation.) Hyperaesthesia (potassa? chloras) 357. Hyperemesis (tannicum purum) 437. Hypertrophy (baryum iodatum) 83. (Ferr. bromat.) 205. (Ferr. iodid.) 221. Of the coats of the stomach (sulph. carbu- ret.) 432. Of the heart (brominum) 92. Of the heart (iodin.) 297. Of the heart (potass, bromid.) 360. Of the heart (po- tass. iodid.) 370. Of the mamma? (iodi- num) 297. Of the spleen (iodin.) 297. Of the thymus (iodin.) 297. Hypochondriasis (auri praeparat.) 65. (Chlorin.) 128. (Strychnina) 423. Ve- ratrina) 448. Hysteralgia (euphorb. ol.) 201. Hysteria (creosoton) 178. (Fuligo) 238. (Granatum) 251. (Lactucarium) 308. (Strychnina) 423. (Veratrina) 448. (Zinci ferrohydrocyanas) 458. Hysteric croup (creosoton) 178. Fainting "(sulphuris carburetum) 431. Convul- r.ions (indigu.ri) 273. Hysterics (ammoniated counter-irritants) 470. Impetigo (acid, hydrocyan.) 11, 14. (Ar- sen. iodat.) 57. (Creosoton) 172, 181.) (Ol. jecin. aselli) 343. Impotence (cubeba?) 184. (Diosma) 192. (Iodinum) 301. (Nux vomica) 329. Incontinence of urine (iodin.) 296. (Nux vomica) 321. Indigestion. (See Dyspepsia.) Indurations, glandular, chronic (carbo animalis) 115. (Hydrarg. deuto-iodur.) 271. Of the pancreas (carbo animalis) 115. Of the pancreas (iodin.) 297. Chro- nic (calendula) 111, 113. Chronic, of the mammae (carbo animalis) 115. Inflammation (aconitin.) £5. (Compres- sion of arteries) 465. Of the bronchia. (See Bronchitis.) Chronic (acid, hydro- cyan.) 9. Chronic (baryum iodatum) 83. Chronic (ol. croton) 335. Chronic, of the eustachian tube (catheterism) 407. Chronic, of the mouth and fauces (chlo- rin. aq.) 136. External (compressio) 461. Of the heart. (See Caiditis.) Internal (acid, hydrocyan.) 9. Of the liver (chlorin. aq.) 134. Of the lungs (ammoniated counter-irritants) 471. Of the lungs. • (See Pneumonia.) Of the pleura (ammoniated counter-irritants) 471. Synovial (compressio) 461. Tho- racic (acid, hydrocyan.) 9. Of the tra- chea (ammoniated counter-irritants) 461. Inflammatory diseases (colchicum) 149. (Cort. adstring. Brazil.) 154. (Morphina) 317. (Ol. sinapis) 347. Integuments, lesions of the (creosoton) 167. Intermittent (cetrarine) 119. (Chlorin. aq.) 133. (Cinchonin.) 138, 140. (Cu- beba?) 184. (Ferr. carb. praec.) 207. (Ferr. cyanur.) 213, 215. (Hippocasta- num) 256. (Indigum) 273. (Phlorid- zina) 349. (Piperina) 351. (Quinina) 376. (Quinina? et cinchon. tannas) 392. (Quinina? sulphas) 383, 386, 389, 391. (Quinina? sulphas impurus) 395. (Re- sina china? praepar.) 393. (Salicina) 396, 397. (Sodae chlorid.) 412. Intertrigo of children (creosoton) 166. Iodkrankheit, 285. lodosis, 285. Iralgia (quinina? sulphas) 387. Ischias (oleum sinapis) 348. (Veratrina) 447. Ischuria (colchicum) 150. Itch (calcis chlorid.) 221. (Chlorin. aq.) 135, 136. (Creosoton) 172, 181. (Fu- ligo) 237. (Sapo mollis) 398. Joints swelled (ammoniated Counter-irri- tants) 470. (Calcis chlorid.) 103,109. Kriebelkrankheit, 401. 500 INDEX OF DISEASES AND THEIR REMEDIES. Labia pudendi, infiltration of (creosoton) 168. Labour, premature, inducing (secale cor- nutum) 405, 410. Leechbites, hemorrhage from (creosoton) 165. Lepra (arsen. iodat.) 57. (Auri pra?parat.) 69. (Carbon, sesqui-iodid.) 117. (Chlo- rin.) 119. (Sulphur, iodid.) 434. Leucorrhcea (chlorin. aq.) 135. (Colchi- cum) 150. (Cort. adstring. Brazil.) 154, 155. (Creosoton) 171. (Cubeba?) 184. (Ferr. iodid.) 221. (Iodinum) 298. (Liq. Ferr. persesquinit.) 225. (Salicina) 396. (Secale comutum) 407,411. Lichen leproides (ferr. carbur.) 211. Liver, affections of the (potassae chloras.) 357. (Berberina) 85. (Chlorin.) 128. (Iodin.) 298. Induration of the (hy- drarg. deuto-iodur.) 271. Indurated (iodinum) 289. Inflammation of the (chlorin. aq.) 134. Obstruction of the (hydrarg. proto-iodur.) 266. Tubercles of the (iodinum) 294. Lumbago (acupunct.) 33. (Ammoniated counter-irritants) 441. (Veratrine) 449. Lungs, gangrene of the (chlorin.) 126. Lupus (hydrarg. deuto-iodur.) 269. (Zinci chlorid.) 454. Non exedens (sulphur. iodid.) 434. Of the ala nasi (ferr. carb. praec.) 207. Of the nose (creosoton) 170. Luxations (diosma) 192. Lymphatism (ferr. iodid.) 220. Measles (chlorin. aq.) 133. Mamma?, hypertrophied (iodinum) 297. Menorrhagia (cort. adstring. Brazil.) 154. (Ferr. cyanur.) 213. Mental affections (auri praeparat.) 65. Metritis, (acid, hydrocyan.) 9. Metrorrhagia (cort. adstring. Brazil.) 154. Miasmata, destroying (calcis chlorid.) 105. Milzbrandkarbunkel (chlorin. aq.) 133. (Zinci chlorid.) 454. Mortification, mildew, 402. Mouth, inflammation of the, chronic (chlo- rin. aq.) 136. Offensive conditions of the (calcis chl irid.) 103. Ulceration of the (calcis chlorid.) 101. Naevi materni (zinci chlorid.) 454. Nephralgia (chimaphila) 120. Nephritis (acid, hydrocyan.) 9. Nervous coughs (tannicum purum) 437. Nervous diseases (auri praeparat.) 65. (Cort. adstring. Brazil.) 154. (Creosoton) 179. (Ferr. carb. praec.) 206. (Ferr. cyanur.) 213. (Fuligo) 239. (Iodinum) 295. (Magnet) 309, 310. (Morphina) 317. (Morphina? acetas) 320. (Ol. sinapis) 348. (Quinina? sulphas) 390. (Zinci ferrohydrocyanas) 458. (Veratrina) 447. Chronic (acid, hydrocyan.) 9. Nervous excitement (lactucarium) 307. Neuralgia (acid, hydrocyan.) 11. (Aco- nitin.) 25. (Ammoniated counter-irri- tants) 470. (Asparag. turion.) 64. (Com- pression of arteries) 465. (Creosoton) 178. (Delphinin.) 190. (Elcctropunct.) 193. (Ferr. carb. praec.) 205. (Ferr. cyanur.) 214. (Galvanism) 477. (Mag- net) 309. (Morphina? acetas) 320. (Morphin. bimeconas) 324. (Moxa) 472. (Nux vomica) 330. (Ol. sinapis) 348. (Potass, cyanid.) 363. (Strychnina) 422. (Veratrina) 448. (Zinci ferrohydrocya- nas) 458. Of the abdomen (codeina) 143. Faciei (artemisia) 62. Faciei (codeina) 145. Faciei (potassa? chlo- ras) 358. Faciei. (See Tic Doulou- reux.) Frontal (galvanism) 478. Of the heart (magnet) 309. Pulmonary (magnet) 309. Neuroses (ol. croton) 335. Nipples, excoriated (acid, pyrolign.) 20. Sore (creosoton) 167. Nodes, gouty (sulphur, carb.) 432. Noma (chlorin. aq.) 134. Odontalgia (ammoniated counter-irritants) 470. (Ol. sinapis) 348. (See Toothach.) Odour, offensive (calcis chlorid.) 104. ffidema (creosoton) 174. Of the feet (acupunct.) 34. Offensive evacuations (calcis chlorid.) 105. Ophthalmia (acid, hydrocyan.) 12. (Acu- punct.) 33. (Creosoton) 173. Ca- tarrhal (calcis chlorid.) 104,108. Chronic (calcis chlorid.) 104. Egyptian (tanni- cum purum) 437. Neonatorum (calcis chlorid.) 104. Purulent (calcis chlorid.) 104. Rheumatic (zinci ferrohydrocyan.) 458. Scrofulous (auri praeparat.) 68. Scrofulous (aurum muriat.) 74. Scrofu- lous (calcis chlorid.) 104,108. Scrofulous (potass, iodid.) 371. Scrofulous (quinina? sulphas) 401. Strumous (fuligo) 237. Strumous (ol. jecinor. aselli) 342. Tarsi (acid, pyrolign.) 20. Tarsi (creosoton) 173. Tarsi (hydrarg. deuto-iodur.) 270. Tarsi (zinci ferrohydrocyanas) 458. Tarsi (zinci iodinum) 460. Orchitis (comprcesio) 462. Osteocopi, syphilitic (strychnina) 423. Otalgia (ol. sinapis) 348. Olorrhoea (creosoton) 167. (Cubeba?) 184. (Potassii bromid.) 360. Ovaries, degenerated (iodin.) 297. Dropsy of the (iodin.) 297. Inflammation of the (hydrarg. cyanur.) 263. Ozaena (calcis chlorid.) 100. (Carbo ani- malis) 115. (Iodinum) 298. Pain, anomalous, of hip and thigh (mor- phin. bimeconas) 324. Nervous and muscular (ammoniated counter-irri- tants) 470. Nervous and muscular (moxa) 472. Nocturnal, in the bones INDEX OF DISEASES AND THEIR REMEDIES. 501 Pain—continued. (zinci ferrohydrocyanas) 458. Severe (acid, hydrocyan.) 11. Palpitations (magnet) 309. (Veratrina) 450. Pancreas, induration of the (carbo anima- lis) 115. Paralysis (acupunct.) 33. (Arnica) 54. (Brucina) 94. (Delphinin.) 190. (Gal- vanism) 477. (Electropunct.) 193. (Iodi- num) 295. (Nux vomica) 329, 332. (Strychnina) 421. (Veratrina) 448. (Zinci chlorid.) 454. (Zinci ferrohydro- cyanas) 458. Of the bladder (diosma) 192. Of the bladder (secale comutum) 408. Of the bladder (strychnina) 422. Of the upper eyelid (ol. croton) 335. Of the facial nerve (strychnina) 422, Lead (brucina) 93. Partial (nux vomi- ca) 329. Of the rectum (nux vomica) 329. Succeeding to apoplexy (nux vo- mica) 329. Paralytic debility (ammoniated counter- irritants) 471. Paraplegia (secale comutum) 408. (Strych- nina) 421. Paroxysmal diseases (secale comutum)407. Parturient efforts defective (secale comu- tum) 403. Pericarditis (ammoniated counter-irritants) 471. Phlebitis (compressio) 461. Phlegmasia (compressio) 461. Phthisis (acid, hydrocyan.) 9. (Acid, py- rolign.) 20. (Aq. picea) 41. (Calcis chlorid.) 100. (Chlorin.) 125,126. (Creo- soton) 174, 180. (Fucus crispus) 235. (Galeopsis) 241. (Iodinum) 292. (Ol. croton) 335. (Ol. jecinor. aselli) 342. (Potassa? chloras) 357. (Tannicum pu- rum) 437. Cough of (codeina) 145. Mucosa (galeopsis) 241. Mucosa (iodi- num) 293. Pituitosa (chimaphila) 122. Sweats of (boletus laricis) 87. Pica (cainca? radix) 97. Pimples (ammoniated counter-irritants) 471. Pityriasis (zinci chlorid.) 454. Plague (chlorin. aq.) 132. Prevention of (chlorin. aq.) 135. Pleurilis. (See inflammation of the pleura.) Pleurodyne (acupunct.) 33. Pneumonia (mannitum) 312. Chronic (hydrarg. cyanuret.) 262. Poisoning by arsenic (ferr. oxyd. hydrat.) 227. By hydrocyanic acid (chlorin. aq.) 134. Polypi cartilaginous (carbo animalis) 115. Mucous (carbo animalis) 115. Porrigo (acid, pyrolign.) 20. (Carbon. sesqui-iodid.) 117. (Fuligo) 239. (Ol. jecin. aselli) 342. Favosa (creosoton) w 173. Favosa (hydrarg. bromid.) 259. Porrigo—continued. Favosa (iodinum) 296. Favosa (potassii bromid.) 360. Scrofulous (auri praepa- rat.) 68. (See Tinea.) Prolapsus vagina? (creosoton) 173. Prosopalgia (ol. sinapis) 348. (Potassae chloras) 358. (Veratrina) 448. (Zinci chlorid.) 455. Prostate, disease of the (diosma) 192. En- largement of the (carbo animalis) 116. Enlarged (iodinum) 289. Enlarged (iodinum) 299. Prurigo (colchicum) 150. Pruritus pudendi muliebris (calcis chlorid.) 103. Vulva? (fuligo) 238. Psora. (See Itch.) Psoriasis (chlorin.) 128. (Creosoton) 173. (Hydrarg. proto-iodur.) 266. (Sulphur. iodid.) 434. Pustule maligne (zinci chlorid.) 454. Putrefaction, checking (calcis chlorid.) 104. Putrescency, tendency to (quinina? et cin- chonin. tannas) 392. Pyrosis (nux vomica) 330. Rectum, catarrh of the (cort. adstring. Brazil.) 154. Remittent fever (ferr. cyanur.) 213. Rhagades (ol. jecin. aselli) 343. Rheumatic pains (hydrarg. deuto-iodur.) 270. Rheumatism (acupunct.) 31. (Ammo- niated counter-irritants) 470. (Ballota lanata) 81. (Cainca? radix) 97. (Chlo- rin.) 128. (Colchicum) 149,150. (Com- pression) 461. (Compression of arte- ries) 465. (Creosoton) 177. (Delphi- nin) 190. (Electropunct.) 193. (Fuli- go) 239. (Galvanism) 475. (Iodinum) 299. (Magnet) 310. (Morphina? acetas.) 321. (Moxa) 472. (Ol. crolon.) 335. (Ol. jecinor. aselli) 341. (Ol. sinapis) 348. (Potato? chloras) 358. (Potass. cyanid.) 363. (Sulphuris carburetum) 431, 432. (Veratrina) 418. Articular (aconit.) 26. Chronic (chimaphila) 120. L'hronic (cubeba?) 184. Chronic (dios- ma) 192. Rickets (ferr. iodid.) 220. (Ol. jecinor. aselli) 341. Ringworm (ammoniated counter-irritants, 471. Roseola (chlorin. aq.) 133. St. Vitus's dance (ammoniated counter-ir- ritants) 470. (Liq. argent, muriat. am- mon.) 48. (Artemisia) 61. (Nux vomi- ca) 329. (Zinci chlorid.) 455. Salivation, mercurial (calcis chlorid.) 102, ]08. Mercurial (iodinum) 300. Profuse (auri pra?parat.) 65. Scabies (acid, pyrolign.) 20. (Chlorin.) 123. (See itch.) Scarlatina (acid, pyrolign.) 20. (Calcis chlo- AND THEIR REMEDIES. 502 INDEX OF DISEASES Scarlatina—continued. rid.) 103. (Chlorin. aq.) 133. (Chlorin. aq.) 135. (Colchicum) 150. Sciatica (acupunct.) 33. (Potass, cyanid.) 363. Gouty (acid, hydrocyan.) 11. Rheumatic (acid, hydrocyan.) 11. Scirrhus (auri praepar.) 69. (Ferr. iodid. 220. (Potass, iodid.) 368. Of the lips (carbo animalis) 115. Of the mammae (calendula) 111. Of the mamma? (carbo animalis) 115. Of the mamma? (iodin.) 297. Of the prostate (carbo animalis) J16. Of the pylorus (acid, hydrocyan.) 12. Of the pylorus (auri praeparat.) 69. Of the pylorus (zinci ferrohydrocyanas) 458. Of the stomach (artemisia) 62. Of the stomach (iodin.) 297. Of the tongue (auri praeparat.) 69. Of the uterus (acid, hydrocyan.) 12. Of the uterus (auri praepar.) 69. Of the uterus (iodin.) 269. Scrofula (acid, pyrolign.) 20. (Auri cy- anidum) 70. (Auri praepar.) 67, 68. (Brominum) 91. (Chlorin.) 128. (Ferr. bromat.) 205. (Ferr. cyanur.) 214. (Ferr. iodid.) 221. (Fucus crispus) 235. (Gentianin.) 246. (Hydrarg. deuto- iodur.) 269. (Iodinum) 289. (Ol. jecin. aselli) 341. (Potassii bromid.) 360. (Potass, iodid.) 370. Scrofulosis (hydrarg. protoiodur.) 266. Scrofulous affections (sodae chloridum) 412. Diathesis (carbo animalis) 115, 116. Diseases (baryum iodatum) 83. Habit ferr. cyanur.) 214. (Aurum mur. na- tronat.) 76. Swellings (calcis chlori- dum) 99. Swellings (carbo animalis) 116. Swellings (chlorin. aq.) 135. Svvel- lings (iodid. quinin.) 305. Swellings (iodinum) 305. Swellings (plumbi iodid.) 355. Swellings (potassii bromi- dum) 360. (Veretrina) 450. Swellings of the glands (calcis chlorid.) 103. Tu- mefaction of the upper lip (aur. muriat. natronat.) 76. Ulcers (potass, iodid.) 371. Scurvy (creosoton) 168. Seasickness (creosote) 177. Sensibility, unusual, of the abdomen (zinci ferrohydrocyanas) 458. Serpents, bites of (cainca? radix) 97. (Gu- aco) 2.52. Serpigo (potass, iodid.) 371. Sleeplessness (lactucarium) 308. (Mag- netism, animal) 478. (Morphin. bime- conas) 324. Sloujjhing ulcers (calcis chlorid.) 101. Small-pox (calcis chloiid.) 101. (Chlorin. aq.) 133. Sore throat (ammoniated counter-irritants) 470. Spasmodic diseases (acid, hydrocyan.) 11. (Acupunct.) 32. (Colchicum) 150. (In- Spasmodic diseases— continued. digum) 273. (Magnet) 309. (Zinc. ferrohydrocyanas) 457. Spasmodic erethism (creosoton) 1/8. Spasms (ammoniated counter-irritants) 470. (Magnet) 309. Sphacelus (acid, pyrolign.) 20. Spina ventosa (ol. jecinor. aselli) 342. Spleen, diseases of the (potass, bromid.) 360. Engorgement of the (quinina? sul- phas) 385. Enlarged (hydrarg. deuto- iodur.) 270. Enlarged (iodin.) 297. In- durated (iodinum) 289. Sprains (creosoton) 167. Violent (ammo- niated counter-irritants) 470. Staubasthma (acid, hydrocyan.) 10. Stomacace (iodinum) 300. Stomach, coats of the, hypertrophy of the (sulph. carbur.) 432. Irritation of (co- deina) 145. Neuropathic disorders of (acid, hydrocyan.) 11. Stricture of the Eustachian tube (catheter- ism) 480. Of the urethra (iodin.) 298. Spasmodic, of the urethra (diosma) 192. Struma varicosa (carbo animalis) 115. Suffocation, sense of (acid, hydrocyan.) 10. Suppuration, profuse (creosoton) 167. Sweating, profuse (boletus laricis) 87. Syphilis (argenti praeparat.) 44. (Auri cyanidum) 70. (Ami pra?parat.) 65, 67. (Aurum muriat.) 74. (Chlorin.) 128. (Hydrarg. bromid.) 259. (Hy. drarg. cyanur.) 262. (Hydrarg. deuto- iodur.) 269. Secondary (ferr. iodid.) 220. Secondary (iodinum) 299. With scrofula (potass, iodid.) 369. Syphilitic affections (potassae chloras) 357. Eruptions (ferr. carb.) 210. Excoria- tions (aurum metallicum) 69. Excres- cences (aurum metallicum) 69. Oste- ocopi (strychnina) 423, 425. Swellings of the bones (potass, iodid.) 372. Ulcers (aurum metallicum) 69. Tabes mescnterica (ferr. iodid.) 220. Taenia (acid, hydrocyan.) 12. (Brayera anthelmintica) 88. (Creosoton) 178. (Euphorb. ol.) 201. (Filix mas) 232. (Granatum.) 248. (Ol. croton) 335. Tarsi inflamed, chronic (creosoton) 173, 181. Teeth, caries of the (calcis chlorid.) 103. Testes, enlarged (iodinum) 289. Enlarged (potass, iodid.) 371. Scrofulous swell- ing of the (potassii bromid.) 360. Tetanus (acid, hydrocyan.) 11. (Ammoni- ated Counter-irritants) 470. (Colchicum) 150. Traumatic (strychnina) 422. Tetter (iodinum) 295. (See Herpes.) Thoracic inflammation (hydrar?. cyanur ) 263. Thymus, hypertrophied (iodin.) 297, Tic douloureux (acid, hydrocyan.) 11. (Aconitin.) 26. (Ammoniated counter^ INDEX OF DISEASES AND THEIR REMEDIES. 503 Tic douloureux—continued. irritants) 470. (Delphinin.) 190. (Gal- vanism) 477. (Strychnina) 423. (Ve- ratrina) 449, 452. (See Neuralgia.) Tinea (calcis chlorid.) 103, 109. (Chlorin. aq.) 135, 136. (Fuligo) 238. (Iodid. sulph.) 306. Tongue, induration of the (auri praeparat.) 69. Tonsils, enlarged (iodinum) 289. Toothach (acid, hydrocyan.) 11. (Acid. pyrolign.) 20. (Acupunct.) 33. (Creo- soton) 174, 181. (Liq. ferr. persesqui- nit.) 224. (Magnet) 309. (Spilanthus oleraceus) 414. Rheumatic (sulph. car- bur.) 433. Tophi, gouty (iodinum) 299. Tremors (Magnet) 309. (Strychnina) 422. From mercury (electro-punct.) 193. Trismus (ammoniated counter-irritants) 470. Tubercles (iodinum) 291. (Ol. jecinor. aselli) 342. Of the lung (chlorin.) 126. (Iodinum) 291. Mesenteric (iodinum) 291. Tumors of the bones (auri. praeparat.) 69. Of the mamma? (ol. jecinor. aselli) 343. Scrofulous (iodid. quinin.) 305. Scrofu- lous (iodinum) 305. Typhoid fever (aq. chlorin.) 133. Typhus (calcis chlorid.) 99. (Chlorin. aq.) 133. (Quinina? et cinchonina? tannas) 392. (Soda? chloridum) 412. Abdomi- nalis (chlorini aq.) 133. Bilious (calcis chloridum) 99. Ulceration of the mouth (calcis chlorid.) 101. Ulcerative process (iodinum) 301. Ulcers (chlorin. aq.) 136. (Creosoton) 167. (Ol. jecinor. aselli) 346. (Soda? chlori- dum) 412. Atonic (creosoton) 167. Atonic (iodid. sulph.) 306. Atonic (zinci chloridum) 456. Cancerous (ca- lendula) 111, 112. Cancerous (chlorin. aq.) 135. Cancerous (ferr. carb. praec.) 205. Cancerous (hydrarg. deuto-iodur.) 270. Cancerous of the face (creosoton) 169. Carious (creosoton) 167. Erosive (zinci chlorid.) 454. Fistulous (creoso- ton) 167. Gangrenous (calcis chlori. dum) 100. Gangrenous (creosoton) 168. Ulcers—continued. Herpetic, &c. (acid, pyrolign.) 19, 20. Herpetic (creosoton) 169. Herpetic (zinci chlorid.) 454. Indolent (creoso- ton) 167. Malignant (creosoton) 168. Malignant (zinci chlorid.) 454. Of the mouth after salivation (potassa? chloras) 358. Phagedenic (zinci chlorid.) 454. Sanious (creosoton) 167. Scorbutic (cre- osoton) 168. Scrofulous (creosoton) 167. Scrofulous (hydrarg. protoiodur.) 266, 268. Scrofulous (iodinum) 304. Scro- fulous (zinci chlorid.) 454. Sloughing (creosoton) 168. Sloughing, from lying (plumb, tannas) 356. Syphilitic (aurum metallicum) 72. Syphilitic (creosoton) 168. Syphilitic (ferr. iodid.) 221. Sy- philitic (hydrarg. cyanuret.) 263. Sy- philitic (hydrarg. proto-iodur.) 266. Sy- philitic, old (zinci chlorid.) 454. Torpid, foul, &c. (calcis chlorid.) 100. Torpid, foul (ferr. cyanur.) 214, 215. Varicose (creosoton) 167. Urethra, diseases of the (diosma) 192. Mu- cous membrane of the, tumefied (carb. anim.) 116. Urinary organs, diseased (chimaphila) 120. Urine, incontinence of (diosma) 192. (Iodin.) 296. Retention of (secale cor- nutum) 408. Urticaria (cort. adstring. Brazil.) 154. Uterus, cancers of the (ferr. carb. praec.) ' 206. Neck of the, fungus of the (aur. nitrico-muriat.) 78. Pain of the (acid. hydrocyan.) 12. Spasmodic pains of the (acid, hydrocyan.) 11. Vagina, inflammation o'. the (fuligo) 238. Varicose veins (acupunct.) 34. Venereal infection, prevention of (chlorin. aq.) 135. Vomiting (acid, hydrocyan.) 11. (Argilla) 52. (Creosote) 177. (Strychnina) 423. Chronic (artemisia) 62. Chronic (calen- dula) 111. Obstinate (calendula) 111. Worms (cainca? radix) 96. (Ol. croton.) 334. (Zinci ferrohydrocyanas) 458. Wounds (calcis chlorid.) 101. Contused (diosma) 192. From dissection (calcis chlorid.) 101. From gunpowder (calcis chlorid.) 102. Painful (acid, hydrocyan.) 11. m m , ' : I li iifii 1 ; llMffl If • ii ills ftli ■ •■*.-u»h itfif ' ■ \t ■ 1 NATIONAL LIBRARY OF MEDICINE NLM 03n33im 0 -i 1 111 1 NLM031933040